緒論分類(lèi)保健課件

1、CHILD AND ADOLESCENTS PSYCHIATRY and MENTAL HEALTHOutlinePreface of Child and Adolescents PsychiatryClassification of Child Mental Disorders Child Mental Health ServicesdefinitionChild and Adolescents Psychiatry is the academic and clinical discipline which studying caring for children and adolescen

2、ts with Emotional disordersbehavioral disordersdevelopmental disorders definitionChild and Adolescents Psychiatry PathogenyMechanismPhenomenaTreatmentPreventionindividualThe field of child and adolescent psychiatry is quite young.1867 Maudsley H. first described insanity of early life in his book Ph

3、ysiolgy and pathology of mind1950 formal training programs in child psychiatry become popular in American1970 quick development The social sciences (social and communal factors, family functioning, parent-child relations) Many basic science contribute to knowledge relavant it The biological science

4、(brain development)The child developmental psychology EducationEpidemiology Xin RE(1992) CBCL 12.97%Li XR (1993) DSM-III-R 14.89%It mean that there are 46770000 children need help in China.Poor outcomesLight and Bailey (1998) report that longitudinal studies find that about half the children with ps

5、ychiatric disorders exhibit the same or similar disorders years later. Conduct disorder related behaviours tend to persistent into adolescence and adult life through drug abuse, juvenile delinquency, adult crime, antisocial behaviour, marital problems, poor employee relations, unemployment, interper

6、sonal problems, and poor physical health (Patterson, DeBaryshe, & Ramsey, 1989). Current states of child mental health Most Scandinavia countries, many European countries and American : about one child psychiatrist for every 50,000 people in the populationIn China :less than 100 child psychiatrist t

7、hroughout the countryNow, many child psychiatry research institutes have been built, including clinics, wards and caring centers for children and adolescents in Beijing, Nanjing, Shanghai, Changsha, Chengdu, Fuzhou, Jinan, and so on. Child mental health clinics have also been built in more cities. S

8、ocial need increasingEmotional quotient (EQ, Garduer H and Salovey P.) The ability to accurate appraisal and expression of emotions in oneself and others to regulate emotion in a way that enhances living to recognize the consensually agreed upon emotional qualities of objects in the environment. The

9、 achievement of one depend upon IQ 20% EQ 80%Classification理想的分類(lèi)是按病因分類(lèi)。但多數(shù)精神疾病病因不明，目前的分類(lèi)是按性質(zhì)，兼顧病因、病理學(xué)分類(lèi)和癥狀學(xué)分類(lèi)分類(lèi)的目的：化繁為簡(jiǎn)，集合障礙中性質(zhì)、表現(xiàn)和結(jié)局相似者作為一個(gè)診斷類(lèi)別，有利于治療和預(yù)后。再按其從屬關(guān)系細(xì)分為病種和病型以兒童孤獨(dú)癥為例 病類(lèi)：心理發(fā)育障礙 病種：廣泛性發(fā)育障礙 病型：兒童孤獨(dú)癥 ClassificationWHO(1992) : International Classification of Disease, Ten Edition(ICD-10)APA(19

10、94):Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV)Chinese Classification of Mental Disorders-Version 3(CCMD-3) 2000 7.Mental retardation, and disorder of psychological developmental with onset usually occurring in childhood and adolescenceChinese Classification of Ment

11、al Disorders-Version 3(CCMD-3) 2000 8. Hyperkinetic, Conduct,and Emotional disorders with onset usually occurring in child and adolescenceClassification71.1 Specific speech articulation disorder71.2 Expressive language disorder71.3 Receptive language disorder71.4 Acquired aphasia with epilepsy71.9 O

12、ther or unspecified developmental disorders of speech and language 70. Mental retardation 71.Developmantal disorder of speech and languageClassification72.1 Specific reading disorder 72.2 Specific spelling disorder72.3 Specific disorder of arithmetical skills 72 Specific developmental disorders of s

13、cholastic skillsClassification75.1 Childhood autism75.2 Atypical autism75.3 Retts syndrome75.4 Childhood disintegrative disorder75.5 Aspergers syndrome75.9 Other or unspecified Pervasive developmental disorders75 Pervasive developmental disorders Classification80. 1 Attention deficit and hyperactivi

14、ty disorder80.2 Hyperkinetic conduct disorder80.9 Other or unspecified hyperkinetic disorder 80. Hyperkinetic disorder83.1 Separation anxiety disorder of childhood 83.Emotional disorders with onset specific to childhood 83.2 Phobia anxiety disorder of childhood 83.3 Social anxiety disorder of childh

15、ood 83.Emotional disorders with onset specific to childhood 83.91 General anxiety with onset specific to childhoodClassification84.1 Elective mutism84.2 Reactive attachment disorder of childhood84.9 Other or unspecified childhood disorders of social functioning 84.Disorders of social functioning wit

16、h onset specific to childhood and adolescence Classification85.1 Transient tic disorder85.2 Chronic motor or vocal tic disorder85.3 Tourettes syndrome85.9 Other or unspecified tic disorder 85.Tic disordersClassification86.1 Nonorganic enuresis86.2 Nonorganic encopresis86.3 Feeding disorder of infanc

17、y and childhood86.4 Pica of infancy and childhood86.6 Stuttering86 Other hehavioral disorders with onset usually occurring in childhood and adolescence 89 Other or unspecified childhood disorders of social functioning兒童心理保健定義根據(jù)不同年齡兒童的心理特點(diǎn)，運(yùn)用心理學(xué)的一般原理，進(jìn)行心理健康教育和訓(xùn)練，促進(jìn)兒童的智力發(fā)展和健康人格的形成，塑造良好的心理素質(zhì)和靈活的社會(huì)適應(yīng)能力，

18、提高兒童的心理健康水平。研究影響兒童心理發(fā)展的各種因素，包括危險(xiǎn)因素與保護(hù)因素。主要是指生活環(huán)境、親子關(guān)系、同伴關(guān)系以及自身行為等社會(huì)心理因素如何影響兒童的心理發(fā)展。 早期發(fā)現(xiàn)、早期診斷、早期干預(yù)各種心理問(wèn)題，預(yù)防后續(xù)問(wèn)題的發(fā)生。國(guó)際國(guó)內(nèi)對(duì)兒童青少年心理衛(wèi)生提出了更高的要求 世界衛(wèi)生組織召開(kāi)了一次“關(guān)愛(ài)兒童青少年心理衛(wèi)生-設(shè)定WHO方向研討會(huì)”，會(huì)議回顧了該領(lǐng)域當(dāng)前的一些問(wèn)題，提出了具體的實(shí)施方案。指出兒童作為弱勢(shì)群體，需要更多的關(guān)愛(ài)；發(fā)展中國(guó)家要制定相關(guān)政策以促進(jìn)兒童的精神衛(wèi)生，保證兒童能夠得到合理的保健，正確的、質(zhì)高價(jià)廉的服務(wù)。 The WHO School Contest, held a

19、s part of World Health Day 2001 which had the theme “Stop Exclusion: Dare to Care” Chinese President Jiang Ze-min in his letter to Dr Blundtland, the secretary-general of WHO, has emphasized Chinese government will mobilize the whole society to create a suitable environment for people with mental di

20、sorders to go back society.國(guó)務(wù)院2001年5月22日發(fā)布的中國(guó)兒童發(fā)展綱要（2001-2010）主要目標(biāo)第5條為：“加強(qiáng)兒童衛(wèi)生保健教育，提供各種形式的兒童心理健康咨詢及不良心理矯正服務(wù)“策略措施第5條為”重視兒童心理衛(wèi)生知識(shí)的普及，在學(xué)校開(kāi)展心理健康課程，逐步在大中城市和其他有條件的地方建立兒童心理健康咨詢和矯正服務(wù)機(jī)構(gòu) 衛(wèi)生部、民政部、公安部、中國(guó)殘疾人聯(lián)合會(huì)發(fā)布的中國(guó)精神衛(wèi)生工作規(guī)劃（20022010）要求加強(qiáng)兒童、青少年學(xué)生心理健康教育和干預(yù)，減緩心理行為問(wèn)題和精神疾病上升趨勢(shì)。 到2005年，在校學(xué)生心理保健知識(shí)知曉率達(dá)到40；到2010年，達(dá)到60。 到

21、2005年，遏止兒童、青少年心理行為問(wèn)題和精神疾病總患病率上升趨勢(shì)；到2010年，兒童、青少年心理行為問(wèn)題和精神疾病總患病率降低到12。 今年我國(guó)精神衛(wèi)生日的主題:“ 快樂(lè)心情，健康行為 關(guān)注兒童青少年情緒行為” 一級(jí)預(yù)防模式（社區(qū)） 1、優(yōu)生：婚前、孕前、產(chǎn)前遺傳咨詢，加強(qiáng)孕期與圍產(chǎn)期保健，減少對(duì)胎兒與新生兒腦發(fā)育的影響。 2、優(yōu)育：通過(guò)孕婦學(xué)校、早教學(xué)校、家長(zhǎng)學(xué)校以及各種形式的科普宣傳等形式，提高家長(zhǎng)的兒童心理知識(shí)，提供正確的養(yǎng)育兒童的方法，促進(jìn)兒童心理與社會(huì)適應(yīng)能力的發(fā)展。 一級(jí)預(yù)防模式（社區(qū)） 3、優(yōu)教：對(duì)于幼兒園、學(xué)校教師要進(jìn)行心理學(xué)知識(shí)的培訓(xùn)，開(kāi)展素質(zhì)教育，根據(jù)兒童的特點(diǎn)采取個(gè)性化的、符合心理學(xué)原理的教育方法，開(kāi)發(fā)兒童的潛能，塑造兒童良好的個(gè)性，形成良好的適應(yīng)能力。 4、優(yōu)化環(huán)境：通過(guò)科學(xué)研究探討影響兒童心理健康的生物與社會(huì)環(huán)境，去除不良的環(huán)境，為兒童構(gòu)筑有利于心理發(fā)展的環(huán)境。二級(jí)預(yù)防模式（基層醫(yī)院） 1、 開(kāi)