Psychopathologie van kinderen en
adolescenten
1. INLEIDING .............................................................................................................................. 5
1.1 Afbakening ........................................................................................................................................ 5
1.2 Diagnostiek ....................................................................................................................................... 7
1.3 Theoretische kaders .......................................................................................................................... 8
2. INFANTPSYCHIATRIE............................................................................................................ 11
2.1 DC 0-3 jaar....................................................................................................................................... 11
2.2 Prevalentie ...................................................................................................................................... 12
2.3 Verdieping: hechtingstoornissen ..................................................................................................... 12
2.4 Verdieping: voedingsstoornissen ..................................................................................................... 16
3. EETSTOORNISSEN ................................................................................................................ 16
3.1 Need-to-know bij eet- en gewichtsproblemen ................................................................................. 16
3.2 DSM-criteria eetstoornissen ............................................................................................................ 18
3.3 Hoe kunnen we een eetstoornis begrijpen? ..................................................................................... 19
3.4 Hoe kunnen we een eetstoornis herkennen? ................................................................................... 20
3.5 Diagnostiek van eetproblemen en -stoornissen ............................................................................... 22
3.6 Behandeling van eetproblemen en -stoornissen .............................................................................. 26
4. OPZETTELIJKE ZELFVERWONDING EN SUÏCIDALITEIT ........................................................ 27
4.1 Opzettelijk zelfverwondend gedrag (ZVG) ....................................................................................... 27
4.2 Suïcidaliteit ..................................................................................................................................... 31
4.3 Behandeling .................................................................................................................................... 34
5. ANGSTSTOORNISSEN EN OBSESSIEVE-COMPULSIEVE STOORNIS...................................... 38
5.1 Inleiding .......................................................................................................................................... 38
5.2 DSM-5 ............................................................................................................................................. 40
5.3 Epidemiologie ................................................................................................................................. 45
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 1
,5.4 Co-morbiditeit ................................................................................................................................. 46
5.5 Etiologie .......................................................................................................................................... 46
5.6 Diagnostiek ..................................................................................................................................... 48
5.7 Aanpak ............................................................................................................................................ 49
5.8 Obsessieve-compulsieve stoornis .................................................................................................... 52
6. LEERSTOORNISSEN .............................................................................................................. 55
6.1 Inleiding .......................................................................................................................................... 55
6.2 Dyslexie: specifieke lees- en spellingsstoornissen ............................................................................ 56
6.3 Dyscalculie: rekenstoornis ............................................................................................................... 58
7. PSYCHOSEN ......................................................................................................................... 59
7.1 Inleiding .......................................................................................................................................... 59
7.2 Diagnostische kenmerken ............................................................................................................... 60
7.3 Co-morbiditeit ................................................................................................................................. 63
7.4 Prevalentie ...................................................................................................................................... 63
7.5 Etiologie .......................................................................................................................................... 63
7.6 Differentiaaldiagnose ...................................................................................................................... 65
7.7 Behandeling .................................................................................................................................... 65
7.8 Farmacotherapie ............................................................................................................................. 66
7.9 Psychosociale interventies .............................................................................................................. 67
7.10 School en sociaal functioneren ........................................................................................................ 68
7.11 Organiseren van zorg....................................................................................................................... 68
7.12 Signaliseringsplan............................................................................................................................ 68
7.13 Beloop en prognose ........................................................................................................................ 69
8. ADHD ................................................................................................................................... 69
8.1 Inleiding .......................................................................................................................................... 69
8.2 Wat is ADHD? .................................................................................................................................. 69
8.3 Prevalentie en beloop ..................................................................................................................... 71
8.4 Co-morbiditeit ................................................................................................................................. 71
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 2
,8.5 Etiologie .......................................................................................................................................... 72
8.6 Neuropsychologische theorieën ...................................................................................................... 73
8.7 Diagnostiek ..................................................................................................................................... 76
8.8 Behandeling .................................................................................................................................... 77
9. TICSTOORNISSEN................................................................................................................. 80
10. GEDRAGSSTOORNISSEN .................................................................................................. 83
10.1 Externaliserend gedrag .................................................................................................................... 83
10.2 DSM-criteria .................................................................................................................................... 85
10.3 Voorkomen, prognose en co-morbiditeit ......................................................................................... 88
10.4 Differentiaal diagnose ..................................................................................................................... 89
10.5 Casussen ......................................................................................................................................... 89
10.6 Etiologie .......................................................................................................................................... 90
10.7 Diagnostiek ..................................................................................................................................... 92
10.8 Behandeling .................................................................................................................................... 93
11. STEMMINGSSTOORNISSEN ............................................................................................. 94
11.1 Klinisch beeld .................................................................................................................................. 94
11.2 Depressie ........................................................................................................................................ 96
11.3 Bipolaire stemmingsstoornis ......................................................................................................... 103
12. MIDDELENMISBRUIK EN VERSLAVING .......................................................................... 107
12.1 Gebruik, misbruik, verslaving ........................................................................................................ 107
12.2 Jongeren en middelenmisbruik...................................................................................................... 108
12.3 Bio-psycho-sociaal model .............................................................................................................. 110
12.4 Adolescentie ................................................................................................................................. 112
12.5 Behandeling .................................................................................................................................. 113
12.6 Special issues: gedragsverslavingen ............................................................................................... 116
13. AUTISMESPECTRUMSTOORNIS ..................................................................................... 118
13.1 Klinisch beeld ................................................................................................................................ 118
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 3
, 13.2 Epidemiologie ............................................................................................................................... 120
13.3 Etiologie ........................................................................................................................................ 122
13.4 Diagnostiek ................................................................................................................................... 125
13.5 Behandeling .................................................................................................................................. 126
13.6 Hoogbegaafdheid .......................................................................................................................... 127
14. TRAUMA ........................................................................................................................ 133
14.1 PTSS en aanpassingsstoornis ......................................................................................................... 133
14.2 Kindermishandeling en complex trauma ....................................................................................... 137
14.3 Pediatrische psychologie en medisch gerelateerd trauma ............................................................. 145
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 4
adolescenten
1. INLEIDING .............................................................................................................................. 5
1.1 Afbakening ........................................................................................................................................ 5
1.2 Diagnostiek ....................................................................................................................................... 7
1.3 Theoretische kaders .......................................................................................................................... 8
2. INFANTPSYCHIATRIE............................................................................................................ 11
2.1 DC 0-3 jaar....................................................................................................................................... 11
2.2 Prevalentie ...................................................................................................................................... 12
2.3 Verdieping: hechtingstoornissen ..................................................................................................... 12
2.4 Verdieping: voedingsstoornissen ..................................................................................................... 16
3. EETSTOORNISSEN ................................................................................................................ 16
3.1 Need-to-know bij eet- en gewichtsproblemen ................................................................................. 16
3.2 DSM-criteria eetstoornissen ............................................................................................................ 18
3.3 Hoe kunnen we een eetstoornis begrijpen? ..................................................................................... 19
3.4 Hoe kunnen we een eetstoornis herkennen? ................................................................................... 20
3.5 Diagnostiek van eetproblemen en -stoornissen ............................................................................... 22
3.6 Behandeling van eetproblemen en -stoornissen .............................................................................. 26
4. OPZETTELIJKE ZELFVERWONDING EN SUÏCIDALITEIT ........................................................ 27
4.1 Opzettelijk zelfverwondend gedrag (ZVG) ....................................................................................... 27
4.2 Suïcidaliteit ..................................................................................................................................... 31
4.3 Behandeling .................................................................................................................................... 34
5. ANGSTSTOORNISSEN EN OBSESSIEVE-COMPULSIEVE STOORNIS...................................... 38
5.1 Inleiding .......................................................................................................................................... 38
5.2 DSM-5 ............................................................................................................................................. 40
5.3 Epidemiologie ................................................................................................................................. 45
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 1
,5.4 Co-morbiditeit ................................................................................................................................. 46
5.5 Etiologie .......................................................................................................................................... 46
5.6 Diagnostiek ..................................................................................................................................... 48
5.7 Aanpak ............................................................................................................................................ 49
5.8 Obsessieve-compulsieve stoornis .................................................................................................... 52
6. LEERSTOORNISSEN .............................................................................................................. 55
6.1 Inleiding .......................................................................................................................................... 55
6.2 Dyslexie: specifieke lees- en spellingsstoornissen ............................................................................ 56
6.3 Dyscalculie: rekenstoornis ............................................................................................................... 58
7. PSYCHOSEN ......................................................................................................................... 59
7.1 Inleiding .......................................................................................................................................... 59
7.2 Diagnostische kenmerken ............................................................................................................... 60
7.3 Co-morbiditeit ................................................................................................................................. 63
7.4 Prevalentie ...................................................................................................................................... 63
7.5 Etiologie .......................................................................................................................................... 63
7.6 Differentiaaldiagnose ...................................................................................................................... 65
7.7 Behandeling .................................................................................................................................... 65
7.8 Farmacotherapie ............................................................................................................................. 66
7.9 Psychosociale interventies .............................................................................................................. 67
7.10 School en sociaal functioneren ........................................................................................................ 68
7.11 Organiseren van zorg....................................................................................................................... 68
7.12 Signaliseringsplan............................................................................................................................ 68
7.13 Beloop en prognose ........................................................................................................................ 69
8. ADHD ................................................................................................................................... 69
8.1 Inleiding .......................................................................................................................................... 69
8.2 Wat is ADHD? .................................................................................................................................. 69
8.3 Prevalentie en beloop ..................................................................................................................... 71
8.4 Co-morbiditeit ................................................................................................................................. 71
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 2
,8.5 Etiologie .......................................................................................................................................... 72
8.6 Neuropsychologische theorieën ...................................................................................................... 73
8.7 Diagnostiek ..................................................................................................................................... 76
8.8 Behandeling .................................................................................................................................... 77
9. TICSTOORNISSEN................................................................................................................. 80
10. GEDRAGSSTOORNISSEN .................................................................................................. 83
10.1 Externaliserend gedrag .................................................................................................................... 83
10.2 DSM-criteria .................................................................................................................................... 85
10.3 Voorkomen, prognose en co-morbiditeit ......................................................................................... 88
10.4 Differentiaal diagnose ..................................................................................................................... 89
10.5 Casussen ......................................................................................................................................... 89
10.6 Etiologie .......................................................................................................................................... 90
10.7 Diagnostiek ..................................................................................................................................... 92
10.8 Behandeling .................................................................................................................................... 93
11. STEMMINGSSTOORNISSEN ............................................................................................. 94
11.1 Klinisch beeld .................................................................................................................................. 94
11.2 Depressie ........................................................................................................................................ 96
11.3 Bipolaire stemmingsstoornis ......................................................................................................... 103
12. MIDDELENMISBRUIK EN VERSLAVING .......................................................................... 107
12.1 Gebruik, misbruik, verslaving ........................................................................................................ 107
12.2 Jongeren en middelenmisbruik...................................................................................................... 108
12.3 Bio-psycho-sociaal model .............................................................................................................. 110
12.4 Adolescentie ................................................................................................................................. 112
12.5 Behandeling .................................................................................................................................. 113
12.6 Special issues: gedragsverslavingen ............................................................................................... 116
13. AUTISMESPECTRUMSTOORNIS ..................................................................................... 118
13.1 Klinisch beeld ................................................................................................................................ 118
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 3
, 13.2 Epidemiologie ............................................................................................................................... 120
13.3 Etiologie ........................................................................................................................................ 122
13.4 Diagnostiek ................................................................................................................................... 125
13.5 Behandeling .................................................................................................................................. 126
13.6 Hoogbegaafdheid .......................................................................................................................... 127
14. TRAUMA ........................................................................................................................ 133
14.1 PTSS en aanpassingsstoornis ......................................................................................................... 133
14.2 Kindermishandeling en complex trauma ....................................................................................... 137
14.3 Pediatrische psychologie en medisch gerelateerd trauma ............................................................. 145
Bron: lessen en powerpoints gegeven door prof. Jurgen Lemiere 4
