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Psychiatry


Answer 9
  1. Evaluation of the child’s self-esteem. Children with tic disorders are frequently the victims of teasing by other children as well as social ostracism.5 Therefore, a detailed evaluation of the child’s self-esteem and use of coping strategies are essential.5 A referral for psychotherapy may be indicated if the child is experiencing feelings of low self-worth or is having difficulty with peer relationships.5 This is particularly true given the fact that tics are often exacerbated by stress.1 Therefore, children with tics may find themselves in a vicious cycle where stress caused by peer teasing exacerbates tics, and the worsening of tics results in increased teasing and subsequent stress. A child’s adaptation capacities, coping mechanisms, and interpersonal skills may play a significant role in outcome.5 Electrocardiography, magnetic resonance imaging, and electromyography are not indicated for the evaluation of a tic disorder in the absence of other neurologic signs or symptoms.5

    REFERENCE
    5. Popper CW, Gammon GD, West SA, Bailey CE. Disorders usually first diagnosed in infancy, childhood or adolescence. In: Hales RE, Yudofsky SC, editors. The American Psychiatric Publishing textbook of clinical psychiatry. 4th ed. Washington (DC): American Psychiatric Pub.; 2003.

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