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Classification of mental disorders of childhood and adolescence

Psychiatric disorders have been estimated to occur in about 20% of children, but only about half of these experience psychosocial impairment, which is commonly used as the threshold by which to defi ne the need for treatment. ‘Psychosocial impairment’ refers to a signifi cant effect of symptoms on functioning in one of the areas in which children are expected to perform: relationships with family, peers and other adults; school work and other aspects of school life; and leisure activities.

Child psychiatric disorders can be divided broadly into three groups: externalising or behavioural disorders, internalising or emotional disorders, and disorders affecting general development. While such a categorisation is helpful, many children presenting with one psychiatric disorder will meet criteria for further psychiatric diagnoses. This comorbidity may complicate the presenting picture and infl uence treatment options. A comprehensive assessment at the outset is important in gaining a full picture f the nature of the problem, the contributing risk factors and the possible treatment options.

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