Chapter 34: Children & Adolescents in Psychiatric Nursing

Children & Adolescents in Psychiatric Nursing examines the crucial concept of resilience, explaining how certain individuals overcome significant hardships like poverty or abuse through emotional intelligence and supportive social networks. The discussion extends to the impact of adverse childhood experiences and prenatal factors, such as maternal nutrition and substance exposure, which can predispose youth to conditions like schizophrenia or fetal alcohol spectrum disorders. In-depth analysis is provided for several major diagnostic categories: pediatric depression, which often presents through somatic complaints and carries a high risk of suicide; bipolar disorder, where irritability and co-occurring attention-deficit hyperactivity disorder symptoms are more common than adult-style grandiosity; and various anxiety disorders, including pediatric obsessive-compulsive disorder and post-traumatic stress disorder. The chapter highlights attention-deficit hyperactivity disorder as the most prevalent behavioral disorder, requiring careful diagnosis based on prolonged symptoms across multiple settings like school and home. It also addresses the updated diagnostic criteria for autism spectrum disorders, emphasizing deficits in social reciprocity, communication delays, and repetitive behaviors. A significant portion is dedicated to the mechanics and consequences of bullying, including physical, relational, and the increasingly pervasive threat of cyberbullying, noting their strong links to emotional distress and suicidal ideation. Nursing interventions are presented through a holistic psychotherapeutic management model that balances the therapeutic nurse-family relationship with "prescription hygiene" in psychopharmacology and a well-structured clinical milieu. This environment prioritizes safety, established norms, and clear limit-setting to support the development of independence in young patients while managing the complexities of their psychiatric care and family dynamics.