CHILD AND ADOLESCENT PSYCHIATRY FOR THE SPECIALTY BOARD REVIEW T his new, thoroughly revised edition of C hild and Adolescent Psychiatry for the Specialty Board Review offers updated information along with the most recent references and knowledge reflected in those changes. The authors especially incorporate new information and changes from DSM-5. Both general and child/adolescent psychiatrists will find this new edition invaluable, not only as a guide for preparing for their first successful board examination, but also as a review in prepar- ing for important recertification exams. The book includes hundreds of multiple-choice ques- tions modeled after the types of questions on the actual boards. This challenging update, with new references and more relevant questions, will help readers to learn new information and be better prepared for their board examinations. Because the authors rewrote the majority of ques- tions to cover a broader knowledge base, readers may find it useful to use the fourth edition as a companion book to the third edition. Hong Shen, MD, is an Associate Clinical Professor in the Department of Psychiatry and Behav- ioral Sciences at the University of California, Davis. As a community-based academic child and adolescent psychiatrist, Dr. Shen provides mental health services in a variety of settings. He gained extensive clinical trial research experience at the UC Davis MIND Institute. He also has special interests in cross-cultural psychiatry. He is actively involved in child and adolescent resident train- ing, general psychiatry resident training, and medical student education among other academic commitments. Robert L. Hendren, DO, is Professor and Vice Chair, Department of Psychiatry and Director, Child and Adolescent Psychiatry at the University of California, San Francisco. His primary areas of research and publication interests are translational clinical pharmacology and nutritional trials using biomarkers for neurodevelopmental disorders such as autism spectrum disorder, dyslexia, ADHD, schizophrenia spectrum disorder, and impulse control disorders. He has over 100 peer-reviewed publications on topics in his field, including five books, many book chapters, and solicited papers. He is Past President of the American Academy of Child and Adolescent Psychiatry and has an active leadership role in various local, state, and national organizations and committees. This page intentionally left blank CHILD AND ADOLESCENT PSYCHIATRY FOR THE SPECIALTY BOARD REVIEW Fourth Edition Hong Shen and Robert L. Hendren First published 2015 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2015 Taylor & Francis The right of Hong Shen and Robert L. Hendren to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Hendren, Robert L., 1949– author. Child and adolescent psychiatry for the specialty board review / Hong Shen, Robert Hendren.—4th edition. p. ; cm. Includes bibliographical references and index. (alk. paper) I. Shen, Hong, 1963– author. II. Title. [DNLM: 1. Mental Disorders—Examination Questions. 2. Adolescent. 3. Child. WS 18.2] RJ499.32 618.92ʹ890076—dc23 2014011256 ISBN: 978-0-415-81809-4 (hbk) ISBN: 978-0-415-81810-0 (pbk) ISBN: 978-0-203-58210-7 (ebk) Typeset in Times by Apex CoVantage, LLC CONTENTS Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Part I: Multiple-Choice Questions 1 Normal Growth and Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 2 Neurodevelopmental Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 3 Schizophrenia Spectrum Disorders and Other Psychotic Disorders . . . . . . . . . .41 4 Bipolar and Related Disorders and Depressive Disorders . . . . . . . . . . . . . . . . . .47 5 Disruptive, Impulse-Control, and Conduct Disorders . . . . . . . . . . . . . . . . . . . . .57 6 Anxiety Disorders, Obsessive-Compulsive and Related Disorders, Trauma- and Stressor-Related Disorders, and Dissociative Disorders . . . . . . . .65 7 Feeding and Eating Disorders, Elimination Disorders, and Obesity . . . . . . . . . .75 8 Somatic Symptoms and Related Disorders and Sleep-Wake Disorders . . . . . . .87 9 Substance-Related and Addictive Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 10 Special Issues (Suicide, Sexual Dysfunction, Gender Dysphoria, AIDS, Paraphilic Disorders, Abuse, and Personality Disorders) . . . . . . . . . . . . . . . . .105 11 Psychological Testing and Rating Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119 12 Psychopharmacology and Medication-induced Movement Disorders and Other Adverse Effects of Medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 13 Psychotherapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139 14 Treatment Settings, Health Care System, and Outcome . . . . . . . . . . . . . . . . . .149 15 Special Topics (Consultation, Forensics, and Public Health) . . . . . . . . . . . . . .157 16 Research Design, Statistics, and Technologies . . . . . . . . . . . . . . . . . . . . . . . . .165 Part II: Clinical Cases 17 Case Histories, Clinical Assessment, Differential Diagnosis, Formulation, and Treatment Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175 v This page intentionally left blank INTRODUCTION Child and Adolescent Psychiatry for the Specialty Board Review is a study guide for the child and adolescent specialty board review and has been highly regarded and pop- ular since the first edition was published approximately 20 years ago. Six years have passed since the third edition was published. Tremendous advances and changes in the field of child and adolescent psychiatry have occurred in the past few years. The two principal child and adolescent psychiatry textbooks referenced in the third edition have new editions. More important, the American Psychiatric Association’s (APA) revised DSM-5 was published in May 2013. In contrast to DSM-IV, which was similar to its predecessors, DSM-5 embodies the first significant changes to psychiatric diagnoses in more than 30 years. This new edition is carefully revised, which offers not only updated information, along with the most recent references and knowledge reflected in those changes, but also incorporates DSM-5 to ensure coverage of the major advances in the classification and diagnoses of child and adolescent disorders represented in DSM-5. G eneral and child/adolescent psychiatrists, residents, medical students, and other professionals will find this new edition not only invaluable as a study guide in preparing for board examinations, recertification examinations, PRITE exams, and the medical students’ clerkship shelf exams but it will also serve as an excellent review of the latest knowledge in the field for those wishing an up-to-date review. The revised book includes a slightly larger number of multiple-choice questions modeled after the types of ques- tions on the actual boards. This revision updates references and the majority of the questions are brand-new, which will help readers review and learn new information and be better prepared for their examinations and their practice. The revised book covers similar subject matter and is divided into similar sections/chapters as the previous edi- tion. However, because The American Board of Psychiatry and Neurology has phased out the oral examinations, the section for mock examinations is eliminated from this new edition. Instead, problem-based clinical cases are used as springboards to cover clinical assessment, differential diagnosis, formulation, and treatment planning. vii This page intentionally left blank REFERENCES Note: With dramatic advances continually being made in the clinical sciences, it is a challenge for physicians to keep abreast both of the modifications in treat- ment that such advances require and of the new drugs being introduced each year. The authors and publisher of this volume have taken care to make certain that the doses of drugs and schedules of treatment are correct and compatible with standards generally accepted at the time of publication. However, it is essential for the reader to become fully cognizant of the information on the instruction inserts provided with each drug or therapeutic agent prior to admin- istration or prescription. F urther, as some of the topics are by nature ambiguous, it is suggested that the reader consult the indicated reference sources for clarification should there be a discrepancy between the answer selected and that which appears in the book. Each question, answer, and explanation can be found in one or more of the basic books on child and adolescent psychiatry, reference books, and published journal articles listed here or in the answers to the questions. The references are cited by number, indicating the appropriate page numbers, with each appropriate answer in the text. 1 . M. K. Dulcan (Ed.) Dulcan’s Textbook of Child and Adolescent Psychiatry (Fourth Edition) . American Psychiatric Publishing, Inc. Arlington, VA, 2010. 2. M. K. Dulcan and M. B. Lake. C oncise Guide to Child & Adolescent Psychiatry (Fourth Edition). American Psychiatric Publishing, Inc. Washington, DC, 2012. 3 . A. Martin, F. R. Volkmar, and M. Lewis (Ed.). Lewis’ Child and Adolescent Psychi- atry: A Comprehensive Textbook (Fourth Edition). Lippincott Williams & Wilkins, Philadelphia, PA, 2007. 4 . Diagnostic and Statistical Manual of Mental Disorders (5th Ed) (DSM-5) Amer- ican Psychiatric Association, American Psychiatric Publishing, Inc. Washington, DC, 2013. ix