Women and child psychiatry
Conduct disorder in children:
In practice, there is a tremendous correlation between conduct disorder in children and antisocial personality disorder (psychopathic), and personality disorder in general. About half of those who develop conduct disorder in childhood develop a personality disorder in adulthood.
But what is childhood conduct disorder that is often diagnosed in children?
If a teenager runs away from school, hits the weak, rebellious against adults and the law, despises others, steals and lies, cheats and burns property, then this teenager often suffers from a behavior disorder, and there is a high probability that he will suffer from a personality disorder in adulthood. .
It is often noted that those adolescents with conduct disorder were brought up in broken families, and that one of their parents, usually the father, had criminal precedents.
It’s believed that there is originally a genetic cause, a nurture reason, and a role model reason for having children with conduct disorder.
The solution for those children who suffer from conduct disorder, is to be firm but affectionate with them, and provide a reward when they do a good good job, and when he does a bad job, the punishment is not by beating, but by confinement for a certain period of time, and by depriving him of some privileges that were offered to him in the beginning
Hyperactivity and lack of focus
Have you heard or seen that naughty child, a lot of movement, a distraction who does not keep quiet and does not stop moving at home and school and who fails in subjects?
This child may suffer from hyperactivity and lack of focus, which usually requires three axes to diagnose:
The first axis: hyperactivity
The second axis: lack of focus
The third axis: impulsivity
Symptoms of hyperactivity: excessive talking, horses, lack of discipline in the queue, frequent destruction of objects, excessive physical movements.
Symptoms of lack of concentration: forgetfulness, loss of purposes, avoidance of long duties, lack of patience, and lack of time in class.
Impulsivity: Doing dangerous things, such as: climbing tall trees, climbing over fences, rushing after the ball in the street, setting fires, getting into fights frequently.
The neural basis associated with the development of ADHD is the following:
First: There is a problem in communication between the front and back of the brain
Second: There is a problem with communication between the two hemispheres of the brain
Three: There is a lack of the neurotransmitter adrenaline in the front of the brain
To treat the last problem, which is the most important, the patient is given a chemicals that achieves a high rate of adrenaline in the brain, so calmness occurs, the patient’s movement eases and focus is achieved.
There are non-pharmacological steps that are taken to deal well with cases of hyperactivity and lack of focus, the most important of these steps are the following:
Encouraging parents and the school to divide the child’s school time into small study meals (every quarter of an hour a study meal and not every 45 minutes)
Encouraging parents to be strict and affectionate with the child at the same time to enhance his ability to discipline and focus
Parents follow the system of reinforcing behavior, meaning that if the child is able to focus and if he is able to control his movement throughout the week, an attractive reward will be waiting for him, but if he shows indifference to discipline, depriving him of a game or the like will be waiting for him at the end of the week. If he fails to be disciplined, but expresses a sincere desire to be disciplined with the instructions, in this case, words of encouragement for the child should be waiting for him at the end of the week.
We must pay attention to the overlap of ADHD with other behavior disorders, so firmness and tenderness are both required in dealing with the patient.
Important points regarding hyperactivity and lack of focus:
First: the genetic factor in hyperactivity and lack of concentration is very high, meaning that the injury of one of the parents greatly affects the injury of the child.
Second: Males suffer from hyperactivity and lack of focus more than females.
Third: Hyperactivity and lack of focus are clear symptoms of lack of concentration in females and not symptoms of hyperactivity, so diagnosing it is more difficult for doctors.
Fourth: Delays in diagnosing a child with hyperactivity and lack of focus and delays in treating him harm the child, reducing his ability to academic achievement and affecting his relationships and self-confidence.
Fifth: A third of those who are treated for hyperactivity and focus with appropriate medications remain constantly in need of medication, and a third of them continue to need medication only when needed (i.e. intense study or intense office work), and a third of them, when young, have almost all the symptoms.
Sixth: Hyperactivity and lack of concentration in adults usually has its roots in childhood.
Seventh: The two biggest causes of poor concentration in people are not hyperactivity and lack of focus, but anxiety disorder and depressive disorder.
Eighth: Indifference to the treatment of hyperactivity and lack of focus, which may lead the patient to become addicted to stimulants or others.
Ninth: In the evaluation of hyperactivity and lack of focus, other causes related to hyperactivity and lack of focus must be excluded, such as: all neurotic disorders, psychotic disorders.
Tenth: If the mother smoked during pregnancy, the risk of her newborn child being affected by hyperactivity and lack of concentration increases.
Psychiatry, pregnancy and lactation:
Children are a blessing from God.
First of all the percentage of pregnancies that carry genetic abnormalities of any kind is 6 percent, and it is God Almighty’s mercy for us that two thirds of this amount are aborted, so the total percentage of births with any type of disability is 2 percent.
Disability means: any kind of disability, from having an extra little finger to severe mental disability.
In general, taking medications during pregnancy makes the incidence of disabilities among newborns increase to about 6 percent, but this is general talk, and in fact things range from the fact that there are medications that greatly increase the incidence of disabilities in newborns, such as medicine
Valproic acid
And the presence of chemicals almost completely do not affect the creation of the fetus.
It is important to understand the following: The development of the fetus’s organs occurs in the first trimester of pregnancy, especially between the second to sixth weeks.
The doctor is required to advise the patient to be on the least amount of necessary medications during pregnancy, especially during the period of fetal development.
Is it wise to always stop all psychiatric medications that the patient takes during pregnancy?
Of course not, as some of the patients who were experiencing suicidal thoughts before starting the medication, some of them will return to experiencing those thoughts after stopping the medication.
Also, women who had hallucinations before pregnancy, may return to hallucinations after stopping the medication.
Likewise, women who stop eating or drinking because of a severe mood disorder may recur when the medication is stopped.
In all of these cases that I mentioned a while ago, it is not wise to continue cutting the medication because cutting the medication may harm the patient and the fetus more than continuing it.
How does the doctor treat the patient in such cases?
He reduces the doses a little, follows the pregnant patient relatively intensively, and may stop the medication in periods of pregnancy or in all pregnancy, according to what he deems appropriate, and may convert the patient from a chemicals that may harm the fetus to a chemicals that most likely will not harm the fetus.
How to reduce the possibility of maternal depression after pregnancy?
First: The husband must be cooperating and attend the birth.
Second: The pregnancy should be desired and planned, and the pregnancy should be under adequate medical care.
Third: The birth should be easy.
Fourth: To take excellent care of the health of the newborn.
Ok, now another question:
Is it permissible for a woman who takes psychiatric chemicals and to breastfeed?
This fact depends on several factors:
First: the age of the child.
Second, the type of medication.
Third: The degree of stability of the mother’s mental, physical and psychological condition.
There are medicines that enter the milk, and there are medicines that do not pass into the milk. It is worth noting that not all medicines that are prohibited during pregnancy are medicines that are prohibited during breastfeeding.
In general, if a newborn is under the age of two months, his brain is more sensitive to chemicals that may be in breast milk of the women who takes psychotropic chemicals than a child who has become older than that.
In general, breastfeeding is a great and beneficial thing for mom and baby