First of all, it is important to realize that the neuropsychiatric diagnosis of a child with neuropsychiatric problems is often (although by no means always) a long and sometimes complicated task without short cuts. The child and adolescent presenting with neuropsychiatric symptoms always needs a neuropsychiatric work-up comprising a psychiatric examination and a neurodevelopmental evaluation. Laboratory work-up of some kind is often required also as is a neuropsychological assessment. It is always difficult to draw the clinical line in deciding what is (and what is not) a ‘neuropsychiatric symptom’. Whenever there is a suspicion of a named disorder reflecting brain problems, a genetic disorder or when there are symptoms such as social withdrawal, empathy deficits, psychotic symptoms (hallucinations, delusions, confusion), pervasive attention deficits, learning problems, motor control problems, tics (motor or vocal), grossly disturbed eating behaviour, or significant weight loss in children or adolescents, a full neuropsychiatric work-up is always required. The neurodevelopmental work-up includes a detailed family history, review of the pregnancy and early developmental history, evaluation of social and academic settings and a developmental and neuromotor evaluation.

Psychiatric examination

The psychiatric history-taking will depend on the type of problem investigated and is suggested in this book in connection with all the named disorders under the heading of ‘Behavioural and Physical Phenotype’.