🧒 Developmental Psychiatry

Age-Stratified Treatment and Lifecycle Management

General Psychiatry Topic 20

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🧬 Core Principle

Psychiatric disorders in youth are NOT miniature versions of adult pathologies

Depression presents as irritability/somatic complaints in children
Brain development requires age-stratified pharmacotherapy
Treatment is tripartite: clinician, patient, family system

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📊 Age-Stratified Phenomenology

Age	Stage	Key Presentations
0-5	Behavioral	ASD signs, tantrums vs pathology
6-12	Latency	ADHD, anxiety (somatic)
13-18	Adolescence	Mood, suicidality, psychosis
18-25	Transition	"Cliff" between systems

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💊 Age-Stratified Pharmacotherapy

Stimulants

3-5: Second line; MPH only
6-12: First line; long-acting
13-18: Monitor diversion

SSRIs

3-5: Avoid if possible
8+: Fluoxetine approved
≤24: BBW—weekly monitoring

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👥 Psychotherapy Adaptations

0-5: Play Therapy, PCIT (live coaching)
6-12: CBT (concrete/visual), Social Skills Groups
13-18: IPT-A (interpersonal inventory), DBT-A (family skills)

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🔄 The Transition "Cliff"

Adult systems lack developmental scaffolding exactly when severe mental illness risk is highest

Student-led IEPs build self-advocacy
Update testing senior year (<3 years old for college)
Must self-identify for disability services

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