10-21 Disorders of Childhood

Question 1

List the most common psychiatric disorders of childhood and their ~prevalence rates

Answer 1

1 = Anxiety d/o’s 8-15% [least likely to be dx]

ADHD 4-8%
Depression 7%

Question 2

Explain the public health implications for untreated psychiatric disorders in youth

Answer 2

—lead to adult mental illness
—↓ success in school —> economic
—↓ overall health
—↑ r/o STDs/teen preg (ADHD)
—↑ r/o car accidents (ADHD)
—4X ↑ in substance abuse (un-tx ADHD)

Question 3

Internalizing vs. Externalizing

Answer 3

internalizing sx: kid feels bad (prototype = MDD)

externalizing sx: unaware anything wrong (ADHD)

Question 4

How does depression present differently chez les enfants?

—Natural Hx?

Answer 4

irritability predominates
—male : female = 1 : 1 (vs. 2:1 f:m w/ older pts up until geri age)
—Persistent Depressed Mood, Interest Loss
—Natural Hx: Unlike ADHD, a Remitting Illness; but 4X r/o developing BPD if unipolar as kid

Question 5

DSM-PC vs. DSM-IV

Answer 5

more “shades of one entity”

Question 6

Best evidence for tx of depression chez les enfants?

Answer 6

-CBT

Question 7

OCD

Answer 7

—prototype of dysregulated 5HT

—SSRIs std of tx

Question 8

3 types of ADHD

Answer 8

Inattentive, Hyperactive/Impulsive, Combined

Question 9

What % of childhood ADHD cases persist into adulthood?

Answer 9

~60% Continue into Adulthood

Question 10

molecular theory behind ADHD?

Answer 10

Dysregulation of NE & DA in Fronto-striatal Systems

Question 11

atomoxetine

Answer 11

nonstimulant norepinephrine reuptake inhibitor, long duration~24-hr coverage

Question 12

Focalin

Answer 12

Dexmethylphenidate
—dextrorotatory enantiomer of methylphenidate
—(NDRI) and releasing agent and thus a psychostimulant

Question 13

Vyvanse

Answer 13

Lysine bound to dexamfetamine

Question 14

Daytrana

Answer 14

transdermal MPH formulation

Question 15

ADHD Gender/Sex differences?

Answer 15

M»»F (4-9:1)

Question 16

Best Evidence-Based Tx plan for ADHD

Answer 16

multimodal:
—psychostimulants
—Behavioral Contingency mgmt @ home + school
—Parent Management Training