ADHD

Question 1

Px

Answer 1

-3 core symps-
Inattention, hyperactivity, impulsiveness.
Occur in more than one env, diag after 6 yr but symps present before.
-assoc probs-
Sleep, low self esteem, poor rels, low academic achievement, accidents.
Comorbs eg LD, coord probs, ASD, tics, CD, ODD, subst misuse, AD, dep , BAD.
Crime, dissoc PD, unemploy.

Question 2

Diffs

Answer 2

Age approp behav in active kids
Atatchment disorder
Hearing impair
LD
High IQ child not stim enough
Behav disorder
AD
S/e eg antihist

Question 3

Aetiology

Answer 3

Genetics
Low birth weight, prem birth. 
Maternal alc, smoking and drug use
Head inj, hypoxia. 
Some metab disorders.
Assoc with ASD.

Question 4

Prognosis

Answer 4

20-30% full synd persists as adult.
Impulsiv and hyperactiv remits early. Inatten often persis.
Poor facs- soc deprivat, high exp emot, parent mental ill, CD, LD, lang disorder.
Untreated- ADHD, conduct disorder, ODD, dissoc PD. Criminality, poor academic, subst abuse, aggress, poor rels, poor employm, STDs and preg.

Question 5

Mx

Answer 5

For mild/mod consid parent interven and indiv therapy first.
Psycho educ.
Behav mx eg realistic expecs, pos reinf, consistency, break down tasks, reduce distraction.
School intervention
Diet and fish oils
Support charities.
-bio-
For severe, medication is first line.
Methylphenidate (ritalin is immed rel version)- CNS stim. S/e eg ANOREXIA AND WL, BP, GI, dry mouth, anx, insom, dysphoria, headache, growth suppress. Acts in daytime only.
Atomoxetine- non stimulant NA reupt inhib. 6wk to work. S/e eg dry motuh, anorexia, NV, headache, fatigue, dysphoria.
Dexamfetamine- CNS stim. Only if refrectory to other tx.