Child Psychiatry

Attention deficit hyperactivity disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD)

-3 subcategories: inattentive, hyperactive-impulsive, combined

-6 symptoms involving inattentiveness/hyperactivity for at least 6 months before age 7.

-Treatment:

Medicatons: CNS stimulants – methylphenidate (Ritalin) is the first line

Dextroamphetamine (dexedrine)

Pemoline (Cylert)

SSRIs/TCAas for adjuvant therapy

Conduct disorder: violation of rights of others and of rules/norms

-most commond child psych diagnosis

-3 acts in the following 4 catgories;

1) aggressive towards others (people or animal)

2) destruction of property

3) deceitfulness

4) violation of rules

-up to 40% risk of developing antisocial personality disorder (gotta be over 18 years old)

Treatment: firm rules that are consistently enforced.

SSRIs for impulsivity, irritiability, mood lability

Lithium for aggression.

-6 months of negative/hostile/defiant behaviour with 4 of the following:

1) loss of temper

2) arguments with adults (how dare he!)

3) defying the adults rules (hahahaha.. man this is all racist against kids!)

4) easily annoyed

5) annoying others (my brother?)

6) anger and resentment (poor kid)

7) spiteful (devil child!)

8) blaming others for misbehaviour

-begins by age 8

Learning disorders: in reading (boys), mathematics (girls?), written expression, NOS.

-rule out hearing or seeing problems beforehand

Mental retardation : IQ below 70. 50-70 is mild mental retardation (most common)

Causes of mental retardation:

-Genetic: Down’s syndrome (most common), Fragile X syndrome (2^nd most common)

-Prenatal: TORCH (toxoplasmosis, other: syphillis/AIDS/alcohol/drugs, Rubella/german measles, Cytomegalovirus/CMV, Herpes simplex)

-Perinatal: anoxia, prematurity, birth trauma

-Postnatal: hypothryoidism, malnutrition, toxin exposure, trauma