What Are the Signs of Bereavement in Children?

The incidence of children's emotional disorders is second only to behavioral problems, and it ranks second among children with mental disorders. Rutter (1981) reported that the prevalence of various emotional disorders in children and adolescents is 2.5%, accounting for one third of the number of child outpatient clinics in urban London. The prevalence rate in Hunan, China was 1.05%, and mood disorders accounted for 2.1% in the Nanjing Children's Psychiatric Clinic. Common types are anxiety, phobia, depression, obsessive-compulsive disorder, and hysteria, but clinical types often overlap and are not easy to type. They are introduced as follows.

Cui Yonghua

(Deputy Chief Physician)

Department of Pediatrics, Beijing Anding Hospital, Capital Medical University

Emotional disorders in children are a group of diseases that occur in childhood and adolescence with the main clinical manifestations of anxiety, horror, depression, or physical dysfunction. The past literature is often called childhood neurosis. Due to children's psychophysiological characteristics and different environments, the clinical manifestations of children's emotional disorders are significantly different from adults. Such disorders have a certain relationship with children's development and circumstances, and have no continuity with adult neurosis.

Western Medicine Name

Emotional disorders in children

English name

emotional disorders

Affiliated Department

Gynecology-Pediatrics

Main cause

Psychosocial factors

Contagious

Non-contagious

Introduction to Children's Emotional Disorders

The incidence of children's emotional disorders is second only to behavioral problems, and it ranks second among children with mental disorders. Rutter (1981) reported that the prevalence of various emotional disorders in children and adolescents is 2.5%, accounting for one third of the number of child outpatient clinics in urban London. The prevalence rate in Hunan, China was 1.05%, and mood disorders accounted for 2.1% in the Nanjing Children's Psychiatric Clinic. Common types are anxiety, phobia, depression, obsessive-compulsive disorder, and hysteria, but clinical types often overlap and are not easy to type. They are introduced as follows.

Children's Emotional Disorders

Overview of Children's Emotional Disorders

Anxiety disorder of childhood is the most common emotional disorder. It is a group of emotional experiences mainly based on fear and anxiety. It can be manifested by physical symptoms, such as non-directional fear, timidity, palpitations, dry mouth, headache, and abdominal pain. It can occur from infants to adolescents.

Anderson et al. Reported in 1987 that the annual prevalence of separation anxiety disorder (SAD) in 11-year-old New Zealand children was 3.5%, and the annual prevalence of excessive anxiety disorder (OAD) was 2.9%. Bow en et al. Reported in 1990 that the prevalence of SAD and OAD in children aged 12 to 16 was 3.6% and 2.4%. Whitaker reports that the lifetime prevalence of OAD in adolescents aged 14-17 is 3.7%. There is still no epidemiological data on childhood anxiety in China.

Causes of emotional disorders in children

Child anxiety is mainly related to psychosocial and genetic factors. Patients are often introverts and emotionally unstable, who develop anxiety when they encounter stress in a home or school environment, and behave as evasion or attachment. Some children had a history of acute scare before onset, such as sudden separation from their parents, the death of a loved one, and an unfortunate accident. If the parents are patients with anxiety disorders, the anxiety of the child can persist and become chronic anxiety. The high incidence in the family and the high incidence of twins in both families suggest that anxiety is genetically related.

Clinical manifestations of emotional disorders in children

1. Clinical characteristics

The main manifestations of anxiety are anxiety, restless behavior, and autonomic nervous system dysfunction. Children of different ages behave differently. Infants show crying and irritability; preschool children can show panic, unwillingness to leave their parents, crying, restlessness, can be accompanied by loss of appetite, vomiting, sleep disturbance and bedwetting, etc .; school-age children are not concentrated and learn in class Declined grades, unwillingness to associate with classmates and teachers, or conflicts with classmates due to anxiety, irritability, and then refused to go to school, run away, etc. Autonomic nervous system dysfunction is mainly sympathetic and parasympathetic nervous system function excitement symptoms, such as chest tightness, palpitations, shortness of breath, sweating, headache, nausea, vomiting, abdominal pain, dry mouth, cold limbs, frequent urination, insomnia, dreaming Wait.

Clinical typing

It can be divided into panic attacks and generalized anxiety clinically according to the onset form, clinical characteristics and course of disease. Panic attacks, as acute onset of anxiety, have a short onset of time, manifested as sudden onset of intense tension, fear, and restlessness, often accompanied by significant autonomic nervous system dysfunction. Generalized anxiety disorder is general persistent anxiety, which is mild in anxiety, but lasts for a long time. Children suffer from nervousness in class, fear of being questioned by teachers, fear of poor grades, etc. They also have autonomic nervous system disorder.

According to the cause and clinical characteristics, it is divided into separated anxiety, excessive anxiety reaction and social anxiety. Separation anxiety is more common in preschool children. It is manifested as feeling deeply disturbed when separated from their loved ones, fearing that unfortunate things will happen after the loved ones leave, refusing to go to bed when they are away, refusing to go to kindergarten or school, crying when they are sent, and autonomic nerves appear. Symptoms of system dysfunction. Excessive anxiety reactions are manifested as excessive worries, anxieties, and unrealistic worries about the future. More common in school-age children, worrying about poor academic performance, fear of darkness, fear of loneliness, often worrying about some small things upset and anxious. Children often lack self-confidence, are sensitive to things, and have autonomic nervous system dysfunction. Children with social anxiety manifest themselves as persistent and excessive nervousness, fear, and trying to avoid, fear of going to kindergarten or school when they are in contact with or in a new environment. They have obvious social and adaptation difficulties.

Diagnosis of emotional disorders in children

Anxiety can be diagnosed based on clinical characteristics, onset form, course of illness, and emotional experience of the child.

1. DSM-IV diagnostic criteria for panic attacks: extreme fear or discomfort for a period of time, more than four of the following symptoms occur suddenly, and reach a peak within 10 minutes. (1) Palpitations, palpitation, or increased heart rate; (2) Sweating; (3) Shivering; (4) Feeling shortness of breath or chest tightness; (5) Feeling of suffocation; (6) Chest pain or discomfort; (7) Nausea or abdominal discomfort (8) feeling dizzy, unstable, light-headed or dizzy; (9) environmental disintegration (unrealism) or personality disintegration (feeling not yourself); (10) fear of losing control or going crazy; (11) fear of Death; (12) paresthesia (numbness or tingling); (13) chills or hot flashes.

2. DSM-IV diagnostic criteria for generalized anxiety disorder: (1) Excessive anxiety and worry about many events and activities on most days of at least 6 months; (2) found it difficult to control themselves Worry; (3) This anxiety and worry are accompanied by more than one of the following six symptoms: restlessness or tension, tiredness, difficulty concentrating or blankness of the mind, irritability, muscle tension, sleep disturbance; (4) this anxiety and worry is not limited to a certain axis I mental disorder; (5) this disorder is not due to a substance (such as a drug) or general physical condition (such as a direct physiological effect caused by hyperthyroidism), Mood disorders, psychotic disorders, or general developmental disorders are also excluded.

Emotional Disorders in Children

Based on the principle of comprehensive treatment, the main treatment is psychological treatment, supplemented by drug treatment. First, understand and eliminate the causes of anxiety disorders, improve the home and school environment, create adaptive processes and environments that are conducive to children, reduce stress and increase self-confidence. Cognitive therapy for children over 10 years of age can achieve good results. Relaxation treatment can reduce the level of physiological alertness to relieve tension and anxiety, but young children have difficulty understanding and self-regulation of this treatment, and it is not easy to carry out. Games and music therapy can achieve certain effects. For parents with anxiety, to help them recognize the adverse effects of their personal weaknesses on children, they must be treated at the same time. For children with severe anxiety, anti-anxiety drugs should be used, such as the use of buspirone, benzodiazepines such as diazepam, lorazepam, alprazolam, and antidepressants such as doxepin , Citalopram, sertraline. ^[1-2]

Children's Emotional Disorders

Overview of Children's Emotional Disorders

Phobia is an extremely strong fear of certain objects or special environments, accompanied by symptoms of anxiety and autonomic nervous system dysfunction, and the things and situations encountered by children are not dangerous or dangerous, but The fear of its performance greatly exceeds the objectively existing degree of danger, and the resulting avoidance and withdrawal behaviors seriously affect the normal learning, life and social of children. This fear is marked by specific developmental stages.

The prevalence of this disorder is not yet known.

The occurrence of this disorder is related to the temperament of children and the fright of accidents. Indirect trauma experience and information transmission also play a very important role in the development of this disorder.

Causes of emotional disorders in children

The unreasonable response caused by this benign and uncertain stimulus of social learning theory is learned. Psychoanalytic theory is caused by anxiety caused by subconscious conflicts, and it is caused by displacement and appearance of the feared objects and situations. The development doctrine suggests that fear and anxiety should be understood during the development process. They may be reasonable for a period of time and unreasonable for another period of time. The doctrine of mutual influence horror occurs and is maintained in specific family interpersonal and social relationships. Other scholars believe that phobia is related to the quality factors of children, such as introverted personality, timidity, strong dependence, and anxiety easily in case of trouble. Experiencing or witnessing unexpected events (such as natural disasters such as car accidents, earthquakes) is also one of the causes of phobias.

Clinical manifestations of emotional disorders in children

The clinical manifestations mainly have the following three aspects: (1) The child has extremely strong and persistent fear of certain objects or special environments, knowing that the subject of terror is not dangerous to himself, but he cannot control his fear and anxiety, and he is extremely distressed. According to the clinical target of terror, they are divided into animal horror, disease horror, social horror, and special environmental horror (such as high places, schools, darkness, squares, etc.). (2) Children with evasive behaviors often escape from the scene of terror. (3) manifestations of autonomic nervous system dysfunction, such as palpitation, shortness of breath, sweating, and elevated blood pressure.

Diagnosis of emotional disorders in children

The child is afraid of something (person) or situation, and has an unusually strong anxious reaction or avoidance behavior, and seriously interferes with his life, learning or interpersonal communication. The child is distressed by this and excludes other mental disorders, which can be diagnosed .

1. DSM-IV diagnostic criteria for special phobia: (1) Excessive or unreasonable significant and persistent fear due to the presence or expectation of a particular object or situation; (2) Upon contact with the stimulus of fear, almost Anxiety reactions occur immediately, without exception, in the form of a panic attack that is limited to this situation or induced by it. This anxiety manifests as crying, tantrums, stuns, or holding on to others; (3) children generally try to avoid this situation, otherwise they endure with extreme anxiety or pain, annoyance; (4) this Avoidance, anxiety, or painful annoyance of the horrible situation can significantly interfere with the individual's normal life, learning or social activities or relationships, or feel significant painful annoyance of this horror; (5) Should be at least 6 months Sickness; (6) This kind of anxiety, panic attack, or horror avoidance associated with special objects or situations cannot be attributed to other mental disorders, such as obsessive-compulsive disorder (such as children with forced thinking about pollution when they are in contact with dirt Fear), social phobia (avoid social occasions because of fear, distress, embarrassment), etc.

The DSM-IV diagnostic criteria for social phobia: (1) problems with age-appropriate social relationships with familiar people, or anxiety among peers; (2) in social situations that are scared, almost inevitable Ground anxiety may take the form of limiting or inducing this occasion. This anxiety may manifest as crying, losing temper, being stunned, or withdrawing from occasions where people are unfamiliar; (3) children generally try to avoid such occasions, otherwise they will be anxious or suffering Patience; (4) such attempts to avoid, anxiety, or painful annoyance of the horror situation, which significantly interfere with the normal life, learning or social activities or relationships of the individual, or feel significant painful annoyance of this horror; There should be at least 6 months of illness; (6) This fear or escape is not a substance (such as drug abuse, therapeutic drugs) or a direct physiological response due to general physical conditions, nor can it be attributed to other mental disorders ( (Such as separation anxiety disorder, some kind of general developmental disorder, or schizotypal personality disorder). (7) If there is some general physical condition or other mental disorder, then "there is a problem in making social relationships with people who are familiar with them, or anxiety in peers" is not relevant.

Emotional Disorders in Children

Comprehensive treatment is needed, mainly psychotherapy, supplemented by medication. Behavioral therapy (including system desensitization, practice desensitization, impact therapy, exposure therapy, positive reinforcement method, demonstration method, etc.) combined with supportive therapy, cognitive therapy, relaxation therapy, and music and game therapy can generally achieve better results. Curative effect. For children with severe symptoms, a small dose of anxiolytic or antidepressant can be given. ^[3-4]

Children with emotional disorders and depression

Overview of Children's Emotional Disorders

Child depression is a disease with emotional depression as the main clinical feature, because children have more masked symptoms, horror and behavioral abnormalities in clinical manifestations. At the same time, because children's cognitive level is limited, unlike adult depression Patients can experience emotional experiences such as guilt and self-blame. Generally speaking, the prevalence of depression in preschool children is very low, about 0.3%, and about 2% to 8% in adolescence. As the age increases, the prevalence tends to increase, and more women than men .

Causes of emotional disorders in children

1. Genetic factors: The importance of genetic factors in the incidence of affective mental disorders has been recognized by most scholars.

2. Psychosocial factors: There are three perspectives on the effects of psychosocial factors on children's depression: (1) The influence of parents on the offspring. The depression of the parents can affect the living environment of the offspring and make the offspring appear. Depressive symptoms, alienation of parent-child relationships, and family disagreements can all cause depression in children. (2) Early life events such as loss of parents, difficulties in life, adversity, and predisposition are the predisposing factors for depression in children. Among them, the impact of adversity on children is not only difficult, but more importantly, parents' attitudes and confidence to overcome difficulties. Cowardly attitudes and lack of confidence will promote children's depression. Special life experiences make children have symptoms of depression, such as natural disasters such as parental divorce, floods, earthquakes, war, being in a concentration camp, physical abuse, sexual and psychological abuse, all of which mean that they can cause important illnesses in children with depression. effect. (3) In terms of psychological mechanism, the sense of helplessness is the main psychological mechanism of depression. Feelings of helplessness often bring people to wait for expectations. Hopeless waiting can lead to emotional depression, negative cognitive activities, and a negative outlook on oneself and his future and the world around him.

3. Psycho-biochemical abnormalities: At present, there is a basically consistent hypothesis that the monoamine neurotransmitter system in children with depression is low in function. The reasons for this view are: all can lead to the synaptic space (between nerve cells) in the central nervous system. Monoamine transmitters can cause depressive symptoms in depleted drugs. Effective antidepressants all suppress the recovery of neurotransmitters in the synaptic space, increasing the level of neurotransmitters in the area, thereby achieving the goal of eliminating symptoms.

Clinical manifestations of emotional disorders in children

Infant depression is mainly caused by the separation of the baby from the parents. The first manifestations are crying, irritability, looking for parents, shrinking, no interest in the environment, reduced sleep, decreased appetite, and weight loss. This symptom can disappear when reunited with the mother. Spitz calls it infantile attachment depression.

Preschool children have not fully developed their language and cognitive abilities, and lack of language description of emotional experience, often manifested as lack of interest in games, decreased appetite, reduced sleep, crying, withdrawal, and reduced activity.

In school age, it can be manifested as inattention, decreased thinking ability, low self-evaluation, memory loss, self-blame and guilt, disinterest in various activities organized by schools and classes, irritability, sleep disturbances, and aggressive behavior And disruptive behavior is also one of the manifestations of depression. In severe cases, some children show hidden depression symptoms such as headache, abdominal pain and physical discomfort.

The symptoms of depression in prepuberty increased significantly. In addition to the symptoms of depression, mental retardation, comprehension and memory, other obvious symptoms are abnormal behavior, aggressive behavior, disruptive behavior, hyperactivity, truancy, lying, suicide by suicide, etc. . The International Classification of Diseases 10th Edition (ICD-10) refers to this type of both depression and conduct problems as "depressive conduct disorder."

Diagnosis of emotional disorders in children

Adult psychiatric diagnosis and classification systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are currently used at home and abroad to help assess and diagnose depression in children and adolescents. The following diagnostic steps are often followed before diagnosis and evaluation:

1. Comprehensive understanding of medical history: including perinatal conditions, growth and development process, family and social environment background, family mental history, parent-child relationship, adaptive ability, academic situation, physical condition, personality characteristics, and presence of major mental stimulation. In addition to the parents and the children themselves, the subjects should include babysitters, teachers and other relatives.

2. Detailed mental and physical examination: Because children have poor ability to describe their emotional experience with speech, physicians mainly make comprehensive judgments by observing their facial expressions, postures, actions, word volume, language intonation, and activities, and they must be repeatedly verified in conjunction with the medical history. Eliminate the interference, and finally determine the symptoms.

3. Necessary auxiliary examinations: The focus is to exclude organic diseases, such as brain CT, electroencephalography, and DST (dexamethasone inhibition test) can be used as diagnostic references.

Emotional Disorders in Children

Some children and adolescents who meet the diagnostic criteria, but heal within a few weeks. Children and adolescents with obvious symptoms of depression need intervention and treatment for more than 6 weeks. Common treatment methods include antidepressant medication and electrical spasm. Treatment, psychotherapy.

1. Antidepressant drug treatment

(1) Tricyclic antidepressants (TCAs) study found that for childhood depression, TCAs and placebo have no significant difference in treatment effect, and the effect of TCAs on adolescent depression is slightly higher than placebo. Children and adolescents have potential cardiac toxic side effects, and even severe cases can lead to death. The treatment of depression in children and adolescents does more harm than good, and most experts recommend that it is no longer used as a first-line treatment for children and adolescents.

(2) New antidepressants Recently, new antidepressants have gradually replaced TCAs for the treatment of adult depression. The investigation also found that serotonin reuptake inhibitors (SSRIs) are widely used in the treatment of children and adolescents, and the amount of prescriptions is increasing year by year. . Although in 2004, the US Food and Drug Administration (FDA) issued a warning that SSRIs antidepressants may increase the risk of suicide in children under 18 and adolescents with depression, requiring pharmaceutical companies to use black labels on their instructions as a warning. . However, the latest research in 2007 found that the use of new antidepressants to treat children and adolescents with depression has more advantages than disadvantages. In SSRIs, fluoxetine is effective in treating depression in children and adolescents. Paroxetine has insufficient evidence in treating depression in children and adolescents. Sertraline and citalopram have not been well documented in treating children and adolescents with depression, but Research suggests that sertraline can be considered in cases where fluoxetine treatment is ineffective.

2.Electrospasm treatment

It is mainly used in children who have suicidal tendency or stiff, antifeedant. Electroconvulsive therapy is still an emergency measure to prevent suicide. Not suitable for children under 12 years old.

3. Psychotherapy

Studies have confirmed that many well-designed and well-structured psychological treatment methods, such as cognitive behavioral therapy (CBT), interpersonal relationship therapy (IPT), family therapy, psychodrama and psychodynamic therapy, can effectively treat adult depression. Among them, there is a lot of evidence for cognitive behavioral therapy (CBT) that can effectively treat depression in children and adolescents, and other methods are yet to be confirmed by further research.

Emotional Disorders in Children

Overview of Children's Emotional Disorders

Obsessive-compulsive disorder (OCD) is a kind of childhood emotional disorder with obsessive-compulsive disorder (OCD) as the main manifestation, accounting for 0.2% to 1.2% of children and adolescent psychiatric inpatients and outpatients. The prevalence of juvenile population in the Flarment survey abroad was 0.8%, and the prevalence rate for life was 1.9%. One third to one half of adults with obsessive-compulsive disorder come from childhood.

The average age of childhood obsessive-compulsive disorder is 9 to 12 years, and 10% of the onsets are before the age of 7. Boys develop an average of 2 years earlier than girls. Early-onset cases are more common in boys, children with family history, and children with tics. The ratio of male to female in younger children was 3.2: 1, and the gender difference narrowed after puberty. Two-thirds of children continue to have this disorder 2-14 years after diagnosis.

Causes of emotional disorders in children

1. Genetic factors: OCD in children is genetically susceptible. Lenane (1990) found that 20% of first-degree relatives of OCD patients can be diagnosed as OCD. There is a genetic correlation between multiple tics and OCD, and they are even considered to be different manifestations of the same gene. Pauls et al. Found that among children with OCD who are 5-9 years old, family members have a higher rate of tics.

2. Brain damage: Brain damage is considered to be one of the causes of OCD. Various brain damage that cause basal ganglia damage can cause OCD. Patients with Parkinson's disease and Huntington's disease have increased rates of OCD after encephalitis. In recent years, it has been found that there is a correlation between OCD and minor chorea, and the incidence of OCD increases in children with minor chorea. Some people have found that the caudate nucleus of patients with childhood-onset OCD has shrunk, and positron emission tomography (PET) examination showed abnormal local glucose metabolism. Although the etiology of OCD is unknown, many clues suggest that it is related to dysfunction of the frontal, marginal, and basal ganglia.

3. Neurotransmitter abnormalities: Serotonin recovery inhibitors can effectively treat OCD, so it is inferred that OCD has serotonin dysfunction. Neurotransmitters such as dopamine may also be involved in the pathogenesis of OCD.

4. Psychological factors: Psychoanalytic theory believes that children's obsessive-compulsive symptoms stem from the development of sexual psychological fixation in the anal period. This period is the period when children undergo toilet training. Parents require children to obey, and children's insistence on unrestricted contradictions lies in children Conflicts are caused internally, leading to hostile emotions in children, and the development of sexual psychology is fixed or partially fixed at this stage. Compulsive symptoms are the external manifestations of psychological conflicts during this period.

5. Parental personality traits: As early as 1962, Kanner realized that most children with obsessive-compulsive disorder live in families whose parents are too perfect. Parents have personality traits such as discipline, step by step, pursuit of perfection, and poor change.

Clinical manifestations of emotional disorders in children

Obsessive-compulsive disorder in children is mainly manifested in two types of obsessions and obsessive-compulsive behaviors.

1. Forced ideas include: (1) Forced suspicion. Suspected that what had been done was not done well, was infected with a certain disease, spoke swear words, and was misunderstood because of bad words. (2) Forced recall. Repeatedly recalling events, music you have heard, words you have spoken, scenes you have watched, etc. If you are interrupted by external factors during the recall, you must start from the beginning, because you are afraid that people will disturb your own memories and become emotionally upset. (3) Compulsive exhaustion. The mind is entangled repeatedly on some issues that lack practical significance, such as indulging in the question of "why people are called rather than dogs." (4) Forced opposition. Think twice about two opposing concepts, such as "good" and "bad", "beauty" and "ugly".

2. Compulsive behavior includes: (1) Forced washing. Repeatedly wash your hands, clothes, face, socks, and teeth. (2) Force counting. Repeatedly count the roadside trees, windows on buildings, passing vehicles and pedestrians. (3) Compulsory ritual actions. Do a series of actions. These actions are often associated with "good", "bad", or "something of special significance". If you are interrupted before completing a series of actions, you must do it again. stop. (4) Forced inspection. Repeatedly check whether the school bag has the books to be learned, whether the money is still in the pocket, whether the doors and windows are pinned, and whether the bicycle is locked. Compulsive symptoms are often accompanied by emotional reactions such as anxiety and irritability. In severe cases, it will affect children's sleep, social interaction, learning efficiency, diet and other aspects.

Diagnosis of emotional disorders in children

Diagnose according to the DSM-IV diagnostic criteria. The diagnostic basis includes compulsive thinking and / or compulsive behavior as the main clinical manifestations; the patient recognizes that these symptoms are excessive and unrealistic, and are distressed by being unable to get rid of them (in young Children may not have this characteristic); symptoms affect daily life, work, study, social activities or social functions; exclude other neuropsychiatric diseases or obsessive-compulsive symptoms, can not be explained by other mental disorders.

Emotional Disorders in Children

1. Drug treatment: Drug treatment is one of the main methods for treating obsessive-compulsive disorder. The results of a large number of treatments for obsessive-compulsive disorder show the effects of chlorpromazine, fluoxetine, sertraline, fluvoxamine, and venlafaxine. better.

2. Psychotherapy: Behavioral therapy and cognitive-behavioral therapy are the most commonly used psychotherapy methods to successfully treat children with obsessive-compulsive disorder. According to the situation of the patient and the experience of the therapist, various specific treatment techniques are selected, such as response prevention and anxiety treatment training. For some severely repeated ritual actions similar to tics, habit reversal training can be used. reversal). Family therapy is also an important method for treating obsessive-compulsive disorder, especially for children with family discord, parental marriage problems, family members with special problems, and role confusion among family members, which is more suitable for family therapy. The goal of treatment is to integrate family members into the treatment system, so that all behavioral issues are publicly displayed, fully understand how each family member has an impact on compulsive sexual behavior, reorganize family relationships, reduce compulsive sexual behavior in children, and gradually form Various benign behaviors.

3. Family therapy: It mainly provides counseling and guidance to parents, eliminates parents' anxiety, corrects their improper parenting methods, encourages parents to establish exemplary behaviors to affect children, and cooperates with good doctors for psychological treatment.

Children with emotional disorders

Overview of Children's Emotional Disorders

Hysteria, also known as hysteria, is a phenomenon of mental disorders caused by individual's obvious emotional factors, such as life events, internal conflicts, cues or self-cues, including conversion disorder and dissociative disorder. Person form. The prevalence of the general population is between 3 and 10%. Children's hysteria has obvious characteristics of collective outbreaks, which occur frequently in school age and girls. The prevalence in rural areas is higher than in cities. The frequency of collective rickets is higher in economically and culturally backward areas.

Etiology and pathogenesis of childhood emotional disorders

(1) High morbidity in hereditary factors suggests heredity.

(2) Hysteria character is rich in emotion, full of exaggerated performance, and full of fantasy. Childhood hysteria attacks are often caused by emotional factors, such as grievances, anger, tension, fear, sudden life events, etc. can cause seizures, improper parenting styles, and more likely to trigger. The child's personality has naive characteristics, showing emotional instability, capriciousness, frivolity, susceptibility to hints, etc. The factors that caused the previous episodes, such as similar situations, things, and conversational content, have hints and can induce recurrence of hysteria. If there are physical diseases, menstrual periods, fatigue, weakness, lack of sleep, etc., it is easy to trigger.

Group attacks often occur in classrooms, classrooms, playgrounds, collective dormitories, or hospital wards. Relevant incentives can lead to collective fear and anxiety, such as facing examinations, teachers being too severe, immunizations, patient-like performance, death or injury of classmates, and meningitis epidemics. And some religious superstitions, disasters, sudden life events, wars, social changes, etc. can also trigger collective hysteria.

(3) Children are mostly primitive stress reactions: excitatory reactions (crying, laughing, irritability, etc.), inhibitory reactions (stiffness, lethargy, paralysis, aphasia, etc.), degenerative reactions (naive behavior, etc.). In adults, it is considered a purposeful response, and snoring attacks occur when they are in distress in order to get out of it.

Clinical manifestations of emotional disorders in children

1. Dissociative type, an emotional outbreak. Early childhood manifestations of crying, making disturbances in the limbs, holding your breath, pale or bruising, loss of control of your bowel movements, etc .; older children showing irritability, crying, impulsiveness, smashing objects, hair curls, tearing clothes, or rolling on the floor and twitching. The duration of the attacks varies and some are forgotten after the attacks. The length of the attack is related to the attention and degree of the surrounding people; in places where there are many people and it is easy to attract the attention of the people, the duration is long.

2. Conversion type is mainly caused by spastic seizures, paralysis, blindness, deafness, and deafness. Such as falling into a coma, with extremities straight or angled bows, limbs paralyzed and unable to walk or move hands, suddenly speechless or hoarse. These symptoms can occur simultaneously or in the same patient. This type of child is rare, and if there are similar attacks, it is more likely to be affected by the surrounding people.

Hysteria manifestations have the following common characteristics: The symptoms have no basis of organic lesions and cannot be explained by neuroanatomy. The rapid and repetitive changes of symptoms do not conform to the law of organic diseases. Self-centeredness, which usually occurs in a noticeable place and time, with exaggerated symptoms and performance. Strong suggestiveness, easy to be triggered by self or the surrounding environment, but also aggravated or improved due to the suggestion.

Diagnosis of emotional disorders in children

1. It has the clinical characteristics of detached or converted hysteria.

2. There is no organic basis to explain the symptoms.

3. There is a psychological or emotional basis to show that there is a clear connection in time with the relationship of stressful events, problems or disorders (even if the child denies this). The disorder must be distinguished from seizures, reactive psychosis and schizophrenia.

Emotional Disorders in Children

Treatment should pay attention to individual treatment, that is, to develop a treatment plan based on the personality, psychological characteristics, etiology, and environment of the child.

1. Physicians must first obtain the children's full trust and the cooperation of parents and teachers before psychotherapy. Ask parents and children separately about their medical history, understand the cause in detail, eliminate the children s nervousness in a conversation, encourage them to speak of their internal pain and contradictions, inform them that the disease can be cured, and rebuild confidence; avoid unnecessary treatment And check to prevent tension and panic from aggravating symptoms; avoid parents' negative language or behavioral hints, and eliminate negative mental factors that cause snoring. Improve school and home environments and eliminate incentives. Suggestive treatment is given after the diagnosis is established. Suggestive treatment is one of the most effective methods for snoring, and it is also helpful for diagnosis and differential diagnosis. Mainly verbal suggestion, when the effect is not good, drug suggestion or acupuncture can be given. Behavioral therapy can also be adopted, such as systemic desensitization, which can gradually cause the psychiatric factors of proto-induced rickets to lose their evoking effect, in order to reduce the onset or cure. Collective psychological treatment should be used for rickets, and children should be divided into groups according to their illness, age, and educational level. Group games and lectures should be selected to explain the cause, eliminate tension, and alleviate physical discomfort.

2. Drug treatment: Diazepam or a small amount of new antipsychotic drugs can be given to the psychiatric symptoms of rickets or spasms. Children should not take medication for a long time, so as not to increase the suggestive effect and consolidate the condition.

3. Other treatments: For patients with rickets spasm, lethargy, and stiffness, acupuncture at points such as Zhonggu, Hegu, Baihui, Neiguan, and Yongquan can be used. ^[5-7]