ADHD

Question 1

developmental risk factors for ADHD

Answer 1

prenatal tobacco exposure
young maternal age
LBW
premature birth weight

Question 2

neuroanatomical differences in ADHD

Answer 2

reductions in overall brain volume
gray matter volume
cortical thickness in assoc cortices
higher volumes of white matter

Question 3

psychosocial determinants of ADHD

Answer 3

stressful events, emotional deprivation, disruptions to the family

exposure to video games/TV –> no more than 2 hours per day

Question 4

most common ADHD sx

Answer 4

hyperactivity, emotional lability, short attention, distractible, can’t finish work, act before thinking, poor organization
aggression/defiance
hyperactivity/impulsivity –> present earlier

Question 5

key criteria for ADHD dx
2 buckets - how many for how long?
sx prior to when?
settings?

Answer 5

interferes w/fxn or development by 1 or 2:
1) inattention - 6+ months of 6+ (5+ if 17y or older)
2) hyperactivity/impulsivity - 6+ months of 6+/5+
several sx present prior to 12y
present in 2+ settings

Question 6

ADHD ddx

Answer 6

anxiety
secondary depression
mania (more waxing/waning of sx, grandiosity, decreased sleep)
learning d/o

Question 7

course of ADHD
first sx to remit/last?
RF’s for persistence?
improves prognosis (3)?

Answer 7

can persist or remit after puberty (12-20)
generally do not remit before 12
15% persist into adulthood
hyperactivity/distractability
family hx, negative life events, co-morbid conduct/depression/anxiety sx

reduce social difficulties
diminish aggression
improve family functioning

Question 8

co-morbid d/o w/ADHD

Answer 8

anxiety, tic, depressive, enuresis

higher risk for substance abuse if have conduct d/o

Question 9

pharmacological tx for ADHD

psychosocial?

Answer 9

stimulants: methylphenidate or dextroamphetamine salts (screen for cardiac)
nonstimulant: atomoxetine
a2-agonists: guanfacine/clonidine

school accommodations/study and social skills training