Childhood Psychiatry Flashcards
Risk factors for ADHD
Family history ADHD
History of abuse/neglect during infancy
DSM criteria for ADHD
Criteria A: persistent symptoms of inattention/impulsivity and/hyperactivity (more than 6 symptoms of each) occurring for at least 6 months, which interferes with development/function and impairs social or occupational/academic functioning
Criteria B: some of the symptoms were present before age 12
Criteria C: several symptoms persist in 2 or more settings
Criteria D: symptoms interfere with social/occupational functioning
Criteria E: symptoms don’t occur exclusively during course of schizophrenia or other psychotic disorders and not due to another medical condition
ADHD symptoms of inattention
DO I CALL An Emergency
Distracted
Organisation difficulties
Instruction following poor - doesn’t finish homework
Careless mistakes/no Close attention to detail
Attention difficulties
Listening problems
Losing things needed for tasks
Activities (forgetful in daily activities)
Engage in activities requiring mental effort avoided
DSM symptoms for hyperactivity/impulsiveness in ADHD
My BSC Qualification Is Totally FRee
Motor driven = on the go
Blurting out answers
Staying seated hard
Can’t wait turn
Quiet play does not happen
Interrupts
Talks excessively
Fidgets/squirms in seat
Runs/climbs inappropriately
What is the first line biological management of ADHD including the dose and types
Methylphenidate 0,5-1mg/kg if older 6 years old which can be increased weekly until improvement
1) immediate acting: 10mg can halve to 5mg
2) long acting: 10mg to 20mg to 30mg
3) concerta = 9-12hr half-life: 18mg to 27mg to 36mg to 54mg
Side effects of methylphenidate
Decreased appetite = weight loss = big breakfast before treatment, monitor weight
Nausea, vomiting
Palpitations, hypertension
Dizziness, headache, irritable
Tics, rebound hyperactivity
Insomnia
Non-stimulant pharmacological treatment for ADHD
Venlafaxine
Atomoxetine (Strattera)
Bupropion (Wellbutrin)
Non-biological treatment for ADHD
Psychoeducation
Psychotherapy - CBT
Social therapy = parenting skills training, schooling, social skills training, family therapy
DSM for autism spectrum disorder
Can only diagnose from age 2
Criteria A: social interaction deficits
1) deficits in non-verbal means of communication
2) problems with developing, maintaining, understanding relationships (due to behaviour)
3) difficulty in emotional reciprocity
Criteria B: need for sameness
1) insistence of sameness/ adherence to routines
2) same category of interests (restricted and fixated)
3) sterotyped/repetitive movements
4) hyper/hyporeactivity to sensory input or unusual interest in sensory stimuli
Criteria C: symptoms (criteria A+B) must new present in the developmental period
Criteria D: clinically significant impairment in important areas of functioning
Criteria E: not better explained by another intellectual disability
What is intellectual disability
A condition with onset during the developmental period with deficits in intellectual and adaptive functions affecting the conceptual, social and practical domains.
DSM criteria for intellectual disability
Criteria A: deficit in intellectual function (planning, executive functioning, problem solving, reasoning, abstract thinking, judgement, academic learning) - confirmed by clinical assessment and standardised testing
Criteria B: deficit in adaptive functioning (failure to meet cultural and social standards for social responsibilities and personal independence eg communication, social participation, independent living, across multiple environments)
Criteria C: onset of intellectual and adaptive deficits during the developmental period
What is separation anxiety disorder
Developmentally inappropriate and excessive fear/anxiety when faced by separation from a major attachment figure
DSM criteria for separation anxiety disorder
Criteria A: developmentally inappropriate and excessive fear/anxiety associated with separation for major attachment figure, with >/=3
>nightmares about separation
>constantly worrying about scenarios causing separation
>distress when anticipating separation
>fear of being alone/without MAF
>refusal to sleep away from home / without MAF
>worry about harm to MAF
>complaints if physical symptoms when separated/anticipating separation
Criteria B: symptoms occuring: children = >4weeks, adults = >6months
Criteria C: causing significant clinical distress
Criteria D: not caused by another medical condition
