ADHD

Question 1

What is ADHD?

Answer 1

• Development disorder of self-regulation, characterised by inattention and hyperactivity/impulsivity

Question 2

What is the pathophysiology of ADHD?

Answer 2

The underlying pathway involves the frontal-striatal-cerebellar networks, with deficits in executive function, particularly response inhibition, vigilance, working memory, and planning

There is a strong genetic component

Question 3

How does ADHD present?

Answer 3

• Fidgets
• Often leaves seat
• Runs, climbs excessively
• Difficulty playing quietly
• ‘On the go’
• Talks excessively
• Blurts out answers
• Difficulty awaiting turn
• Interrupts others

Question 4

What are some risk factors?

Answer 4

• Difficult temperament
• Poor parenting skills
• Family dysfunction
• Child abuse, particularly deprivation
• Development delay
• Language disroders
• Learning difficulties
• Anxiety/mood disorders
• Sleep disorders
• Medical conditions eg very low birht weight, acquired brain injury

Question 5

How is ADHD managed?

Answer 5

• Stimulant medications
• Parental behaviour management
• Classroom behaviour management
• Management of co-morbidities
  ○ Special education
  ○ Tx anxiety and depression
• Structured parenting programmes and parent support groups

Question 6

What are some co-morbidities?

Answer 6

• Learning difficulties
• Language disorder
• Oppositional defiant disorder
• Conduct disorder
• Anxiety, mood disorder
• Developmental coordination disorder
• Tics, Tourette syndrome

Question 7

What are the DSM5 criteria for ADHD

Answer 7

A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning characterised by either
1. Inattention
2. Hyperactivity
B. Symptoms were present prior to aged 12
C. Symptoms present in two or more settings
D. Impact in social, occupational, or academic function
E. Symptoms not occurring during the course of schizophrenia or other psychotic disorder or are better explained by another mental disorder