KINDER – EN JEUGDPSYCHOPATHOLOGIE EN PSYCHIATRIE
Handboek moet niet gekend zijn enkel de slides.
Kinder – en jeugdpsychopathologie en psychiatrie ................................................................................................ 1
Korte inleiding ..................................................................................................................................................... 5
K&J-psychopathologie ..................................................................................................................................... 5
Ontwikkeling centraal ................................................................................................................................. 7
Historiek ........................................................................................................................................................ 10
~ veranderende positie van het kind doorheen de geschiedenis ............................................................. 10
Eerste “kinderpsychiatrische behandeling” .............................................................................................. 11
Eerste kinderpsychiatrische beschrijvingen .............................................................................................. 12
Eerste leerboeken kinderpsychiatrie ........................................................................................................ 13
Eerste hulpverleningscentra ..................................................................................................................... 14
Classificatie .................................................................................................................................................... 14
Van DSM-IV naar DSM-5 ........................................................................................................................... 14
Classificatie DC 0-5 .................................................................................................................................... 16
Neurobiologische ontwikkeling ..................................................................................................................... 17
Ontwikkeling ............................................................................................................................................. 17
Wat drijft deze ontwikkeling? ................................................................................................................... 18
Neurobiologische ontwikkeling ................................................................................................................. 18
i.Neurobiologische ontwikkeling ........................................................................................................... 21
Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................... 21
Les 2: Autismespectrum .................................................................................................................................... 25
Normale ontwikkeling (0 -2 jaar)................................................................................................................... 25
I.1. Autismespectrumstoornis (ASS) DSM-5 .................................................................................................. 26
I. 1. Autismespectrumstoornis (ASS) Historiek.............................................................................................. 26
I.1. Autismespectrumstoornis (ASS) DSM-prevalentie .................................................................................. 27
I.1. Autismespectrumstoornis (ASS) prevalentie........................................................................................... 27
I.1. Autismespectrumstoornis (ASS) DSM-5 .................................................................................................. 28
College 3: ADHD ................................................................................................................................................ 36
i.Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................. 36
Normale ontwikkeling van 6-12j ................................................................................................................... 36
I.2. Aandachtsdeficiëntie-/hyperactiviteitsstoornis ...................................................................................... 38
Controversiële diagnose: voor en tegenstanders over het label van ADHD ............................................ 38
Historiek .................................................................................................................................................... 38
3 kernmerken: ........................................................................................................................................... 41
ADHD: 3 presentaties ................................................................................................................................ 42
1
, Prevalentie van ADHD wereldwijd ............................................................................................................ 47
ADHD doorheen de levensloop ................................................................................................................. 48
Is ADHD goedaardig? Prognose................................................................................................................. 48
Impact op school ....................................................................................................................................... 49
ADHD prognostisch belang voor antisociaal gedrag bij volwassenen ....................................................... 50
Differentiaal Diagnose / comorbiditeit ..................................................................................................... 51
ADHD-label als stigma? ............................................................................................................................. 51
Les tics en tourette............................................................................................................................................ 53
i.Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................. 53
Tics en Tourette ............................................................................................................................................ 54
Enkelvoudige motorische tics/clonische tics ............................................................................................. 54
Tics ............................................................................................................................................................ 55
Tics: indeling .............................................................................................................................................. 56
YGTSS: yale global tic severity rating scale (instrument) .......................................................................... 57
Wireless wearable sensors voor ticdetectie ............................................................................................. 58
Tics ............................................................................................................................................................ 59
Premonitory urges................................................................................................................................. 59
Coprofenomenen .................................................................................................................................. 60
Differentiaal diagnose ................................................................................................................................... 61
Historiek ........................................................................................................................................................ 61
Voorkomen.................................................................................................................................................... 62
Comorbiditeit tics .......................................................................................................................................... 64
Primaire en secundaire tics ........................................................................................................................... 64
Leven met Tourette: kinderen ...................................................................................................................... 65
Waarom “psychopathologie” ? ..................................................................................................................... 65
Leven met Tourette: volwassenen ................................................................................................................ 65
Documentaire: Tourette and me .................................................................................................................. 66
Trauma-en stressorgeraleteerde stoornissen ................................................................................................... 66
I.trauma ......................................................................................................................................................... 66
Trauma en ontwikkeling ............................................................................................................................ 66
Wat is een traumatische ervaring? ........................................................................................................... 67
Negatieve levensgebeurtenissen? ............................................................................................................ 68
Trauma typologie ...................................................................................................................................... 69
Vluchtelingen ............................................................................................................................................ 69
Belang bij kinderen en jongeren? ............................................................................................................. 70
Definitie trauma-gerelateerde klinische beelden volgens duur symptomatologie .................................. 70
Peri-traumatische reacties .................................................................................................................... 71
2
, Belang van context .................................................................................................................................... 71
Epidemiologie ............................................................................................................................................ 72
Post-traumatische stressstoornis bij kinderen .......................................................................................... 73
Acute Stress stoornis / PTSD: symptoom clusters ..................................................................................... 73
Acute Stress stoornis / PTSD: specificatie ................................................................................................. 75
Complex trauma ............................................................................................................................................ 75
Complex trauma in kindertijd ................................................................................................................... 75
Trauma-ontwikkelingsstoornis .................................................................................................................. 76
Les: Trauma- en stressorgerelateerde stoornissen ........................................................................................... 78
II.Hechting(sstoornissen)............................................................................................................................... 78
Normale ontwikkeling 0-3 jaar: hechting .................................................................................................. 78
Hechtingstheorie van Bowlby ............................................................................................................... 79
Hechting in DYADE (tussen primaire verzorger en baby) .......................................................................... 80
Ouderlijke sensitiviteit .............................................................................................................................. 80
Hechtingstheorie ....................................................................................................................................... 81
Ainsworth strange situation paradigma .................................................................................................... 81
Hechtingstypologie Ainsworth Paradigma ............................................................................................ 82
4e type ....................................................................................................................................................... 82
Hechtingsstoornis ~ Inconsistent ouderschap .......................................................................................... 83
Validiteit hechtingsclassificatie ................................................................................................................. 83
Van hechting naar hechtingsstoornis ........................................................................................................ 84
DSM-5: hechtingsstoornissen.................................................................................................................... 84
Reactieve hechtingsstoornis ................................................................................................................. 84
Ontremd-sociaalcontactstoornis ........................................................................................................... 85
Kind van de rekening… .......................................................................................................................... 85
Kindfactoren… ....................................................................................................................................... 85
Hechtingstypologie en hechtingsstoornissen........................................................................................ 86
Associaties en Differentiaal diagnose ................................................................................................... 86
Besluit........................................................................................................................................................ 86
Voorbeeld: Roemeense Adoptiestudies .................................................................................................... 86
III. kindermishandeling .................................................................................................................................. 89
Concept: ACE’s/ adverse childhood experiences ...................................................................................... 90
ACEs en outcome ...................................................................................................................................... 91
Kindermishandeling: impact ..................................................................................................................... 91
Kindermishandeling: effecten van toxische stress .................................................................................... 93
BESLUIT ..................................................................................................................................................... 93
Complex trauma ........................................................................................................................................ 94
3
, Developmental Trauma Disorder .............................................................................................................. 94
Besluit........................................................................................................................................................ 95
IV. gedragsstoornissen ...................................................................................................................................... 95
Normale ontwikkeling 2-6 jaar ...................................................................................................................... 96
Terrible “two”: rond 2 jaar ............................................................................................................................ 97
Temper tantrums .......................................................................................................................................... 98
Boosheid heeft een boodschap! ................................................................................................................... 98
Fysieke agressie en ontwikkeling .................................................................................................................. 99
Taalontwikkeling en agressie ...................................................................................................................... 100
Gedragsproblemen en sociale vaardigheden .............................................................................................. 100
ADHD prognostisch belang voor antisociaal gedrag bij volwassenen ......................................................... 101
Wanneer ontstaat antisociaal gedrag bij ADHD? ........................................................................................ 102
Adolescentie = 2de gevoelige periode.......................................................................................................... 102
Gender ........................................................................................................................................................ 103
Types agressie ............................................................................................................................................. 103
Voorspellend ........................................................................................................................................... 104
Reactief/proactief ................................................................................................................................... 104
Delinquentie en sociale competentie ......................................................................................................... 105
Gedragsstoornissen in DSM-5 ..................................................................................................................... 105
Definitie ....................................................................................................................................................... 106
Oppositioneel opstandige gedragsstoornis................................................................................................. 106
Periodiek explosieve stoornis...................................................................................................................... 108
Normoverschrijdende gedragsstoornis ....................................................................................................... 108
Gedragsstoornissen en Socio-economische status ..................................................................................... 111
Het geweten ................................................................................................................................................ 111
Gewetensvorming 2-6 jaar ...................................................................................................................... 112
Morele ontwikkeling ............................................................................................................................... 112
Geweten als mediator ............................................................................................................................. 113
Overzicht en besluit ........................................................................................................................................ 114
Overzicht ..................................................................................................................................................... 114
Selectief mutisme ........................................................................................................................................ 115
Selectief mutisme: prognose................................................................................................................... 117
Overige psychiatrische beelden op kindermaat .......................................................................................... 117
Psychose .................................................................................................................................................. 118
Psychose: uitdagingen ......................................................................................................................... 118
Depressieve stemmingsstoornis ............................................................................................................. 119
Bipolaire stemmingsstoornis ................................................................................................................... 120
4
Handboek moet niet gekend zijn enkel de slides.
Kinder – en jeugdpsychopathologie en psychiatrie ................................................................................................ 1
Korte inleiding ..................................................................................................................................................... 5
K&J-psychopathologie ..................................................................................................................................... 5
Ontwikkeling centraal ................................................................................................................................. 7
Historiek ........................................................................................................................................................ 10
~ veranderende positie van het kind doorheen de geschiedenis ............................................................. 10
Eerste “kinderpsychiatrische behandeling” .............................................................................................. 11
Eerste kinderpsychiatrische beschrijvingen .............................................................................................. 12
Eerste leerboeken kinderpsychiatrie ........................................................................................................ 13
Eerste hulpverleningscentra ..................................................................................................................... 14
Classificatie .................................................................................................................................................... 14
Van DSM-IV naar DSM-5 ........................................................................................................................... 14
Classificatie DC 0-5 .................................................................................................................................... 16
Neurobiologische ontwikkeling ..................................................................................................................... 17
Ontwikkeling ............................................................................................................................................. 17
Wat drijft deze ontwikkeling? ................................................................................................................... 18
Neurobiologische ontwikkeling ................................................................................................................. 18
i.Neurobiologische ontwikkeling ........................................................................................................... 21
Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................... 21
Les 2: Autismespectrum .................................................................................................................................... 25
Normale ontwikkeling (0 -2 jaar)................................................................................................................... 25
I.1. Autismespectrumstoornis (ASS) DSM-5 .................................................................................................. 26
I. 1. Autismespectrumstoornis (ASS) Historiek.............................................................................................. 26
I.1. Autismespectrumstoornis (ASS) DSM-prevalentie .................................................................................. 27
I.1. Autismespectrumstoornis (ASS) prevalentie........................................................................................... 27
I.1. Autismespectrumstoornis (ASS) DSM-5 .................................................................................................. 28
College 3: ADHD ................................................................................................................................................ 36
i.Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................. 36
Normale ontwikkeling van 6-12j ................................................................................................................... 36
I.2. Aandachtsdeficiëntie-/hyperactiviteitsstoornis ...................................................................................... 38
Controversiële diagnose: voor en tegenstanders over het label van ADHD ............................................ 38
Historiek .................................................................................................................................................... 38
3 kernmerken: ........................................................................................................................................... 41
ADHD: 3 presentaties ................................................................................................................................ 42
1
, Prevalentie van ADHD wereldwijd ............................................................................................................ 47
ADHD doorheen de levensloop ................................................................................................................. 48
Is ADHD goedaardig? Prognose................................................................................................................. 48
Impact op school ....................................................................................................................................... 49
ADHD prognostisch belang voor antisociaal gedrag bij volwassenen ....................................................... 50
Differentiaal Diagnose / comorbiditeit ..................................................................................................... 51
ADHD-label als stigma? ............................................................................................................................. 51
Les tics en tourette............................................................................................................................................ 53
i.Neurobiologische ontwikkelingsstoornisen (nieuw hoofdstuk) .................................................................. 53
Tics en Tourette ............................................................................................................................................ 54
Enkelvoudige motorische tics/clonische tics ............................................................................................. 54
Tics ............................................................................................................................................................ 55
Tics: indeling .............................................................................................................................................. 56
YGTSS: yale global tic severity rating scale (instrument) .......................................................................... 57
Wireless wearable sensors voor ticdetectie ............................................................................................. 58
Tics ............................................................................................................................................................ 59
Premonitory urges................................................................................................................................. 59
Coprofenomenen .................................................................................................................................. 60
Differentiaal diagnose ................................................................................................................................... 61
Historiek ........................................................................................................................................................ 61
Voorkomen.................................................................................................................................................... 62
Comorbiditeit tics .......................................................................................................................................... 64
Primaire en secundaire tics ........................................................................................................................... 64
Leven met Tourette: kinderen ...................................................................................................................... 65
Waarom “psychopathologie” ? ..................................................................................................................... 65
Leven met Tourette: volwassenen ................................................................................................................ 65
Documentaire: Tourette and me .................................................................................................................. 66
Trauma-en stressorgeraleteerde stoornissen ................................................................................................... 66
I.trauma ......................................................................................................................................................... 66
Trauma en ontwikkeling ............................................................................................................................ 66
Wat is een traumatische ervaring? ........................................................................................................... 67
Negatieve levensgebeurtenissen? ............................................................................................................ 68
Trauma typologie ...................................................................................................................................... 69
Vluchtelingen ............................................................................................................................................ 69
Belang bij kinderen en jongeren? ............................................................................................................. 70
Definitie trauma-gerelateerde klinische beelden volgens duur symptomatologie .................................. 70
Peri-traumatische reacties .................................................................................................................... 71
2
, Belang van context .................................................................................................................................... 71
Epidemiologie ............................................................................................................................................ 72
Post-traumatische stressstoornis bij kinderen .......................................................................................... 73
Acute Stress stoornis / PTSD: symptoom clusters ..................................................................................... 73
Acute Stress stoornis / PTSD: specificatie ................................................................................................. 75
Complex trauma ............................................................................................................................................ 75
Complex trauma in kindertijd ................................................................................................................... 75
Trauma-ontwikkelingsstoornis .................................................................................................................. 76
Les: Trauma- en stressorgerelateerde stoornissen ........................................................................................... 78
II.Hechting(sstoornissen)............................................................................................................................... 78
Normale ontwikkeling 0-3 jaar: hechting .................................................................................................. 78
Hechtingstheorie van Bowlby ............................................................................................................... 79
Hechting in DYADE (tussen primaire verzorger en baby) .......................................................................... 80
Ouderlijke sensitiviteit .............................................................................................................................. 80
Hechtingstheorie ....................................................................................................................................... 81
Ainsworth strange situation paradigma .................................................................................................... 81
Hechtingstypologie Ainsworth Paradigma ............................................................................................ 82
4e type ....................................................................................................................................................... 82
Hechtingsstoornis ~ Inconsistent ouderschap .......................................................................................... 83
Validiteit hechtingsclassificatie ................................................................................................................. 83
Van hechting naar hechtingsstoornis ........................................................................................................ 84
DSM-5: hechtingsstoornissen.................................................................................................................... 84
Reactieve hechtingsstoornis ................................................................................................................. 84
Ontremd-sociaalcontactstoornis ........................................................................................................... 85
Kind van de rekening… .......................................................................................................................... 85
Kindfactoren… ....................................................................................................................................... 85
Hechtingstypologie en hechtingsstoornissen........................................................................................ 86
Associaties en Differentiaal diagnose ................................................................................................... 86
Besluit........................................................................................................................................................ 86
Voorbeeld: Roemeense Adoptiestudies .................................................................................................... 86
III. kindermishandeling .................................................................................................................................. 89
Concept: ACE’s/ adverse childhood experiences ...................................................................................... 90
ACEs en outcome ...................................................................................................................................... 91
Kindermishandeling: impact ..................................................................................................................... 91
Kindermishandeling: effecten van toxische stress .................................................................................... 93
BESLUIT ..................................................................................................................................................... 93
Complex trauma ........................................................................................................................................ 94
3
, Developmental Trauma Disorder .............................................................................................................. 94
Besluit........................................................................................................................................................ 95
IV. gedragsstoornissen ...................................................................................................................................... 95
Normale ontwikkeling 2-6 jaar ...................................................................................................................... 96
Terrible “two”: rond 2 jaar ............................................................................................................................ 97
Temper tantrums .......................................................................................................................................... 98
Boosheid heeft een boodschap! ................................................................................................................... 98
Fysieke agressie en ontwikkeling .................................................................................................................. 99
Taalontwikkeling en agressie ...................................................................................................................... 100
Gedragsproblemen en sociale vaardigheden .............................................................................................. 100
ADHD prognostisch belang voor antisociaal gedrag bij volwassenen ......................................................... 101
Wanneer ontstaat antisociaal gedrag bij ADHD? ........................................................................................ 102
Adolescentie = 2de gevoelige periode.......................................................................................................... 102
Gender ........................................................................................................................................................ 103
Types agressie ............................................................................................................................................. 103
Voorspellend ........................................................................................................................................... 104
Reactief/proactief ................................................................................................................................... 104
Delinquentie en sociale competentie ......................................................................................................... 105
Gedragsstoornissen in DSM-5 ..................................................................................................................... 105
Definitie ....................................................................................................................................................... 106
Oppositioneel opstandige gedragsstoornis................................................................................................. 106
Periodiek explosieve stoornis...................................................................................................................... 108
Normoverschrijdende gedragsstoornis ....................................................................................................... 108
Gedragsstoornissen en Socio-economische status ..................................................................................... 111
Het geweten ................................................................................................................................................ 111
Gewetensvorming 2-6 jaar ...................................................................................................................... 112
Morele ontwikkeling ............................................................................................................................... 112
Geweten als mediator ............................................................................................................................. 113
Overzicht en besluit ........................................................................................................................................ 114
Overzicht ..................................................................................................................................................... 114
Selectief mutisme ........................................................................................................................................ 115
Selectief mutisme: prognose................................................................................................................... 117
Overige psychiatrische beelden op kindermaat .......................................................................................... 117
Psychose .................................................................................................................................................. 118
Psychose: uitdagingen ......................................................................................................................... 118
Depressieve stemmingsstoornis ............................................................................................................. 119
Bipolaire stemmingsstoornis ................................................................................................................... 120
4
