Distress and Disorder

Fernanda Garcia-CostasChild and Adolescent Consultant Psychiatrist

Plym Bridge HouseFernanda.garcia-costas@nhs.net

Distress

• Distress needed for the diagnosis of mental disorder in many conditions as depression, anxiety, obsessive compulsive disorder, post traumatic stress disorder...

• No possibility of diagnosis without certain level of distress

...distress without disorder

• Distress due to normal transitions, challenges and losses (associated with education and work, family life, relationships)

• Distress associated with social deprivation, exclusion or persecution.

• Distress associated with physical illness.

Childhood psychiatric disorder: Definition

• Persistent disturbance of behaviour, emotions or relationships that is abnormal for the socio-cultural background and stage of development and is accompanied by impaired social and personal functioning and/or disturbance of development.

• All of the above needed for diagnosis of disorder, not distress in isolation

Developmental context

• Year 1: Attachment to the primary care giver• Year 2 : Beginning to be independent: – Child learns to feed and toilet– Move around independently– Communicate using language

• Year 3-5:– Play creatively– Links with others– Further development of language skills

Dev context. Cont

• Year 5-7: – Learning to relate to other children– Build up a sense of self esteem

• Adolescence:– Learns to become independent and separated from

parents– Relationships outside the home incl sexual relationships– Develops academic and physical skills– Develops sense of his/her own identity