ADHD and Autism Flashcards
What is Attention Deficit Hyperactive Disorder?
Co-occurring cluster of impairing symptoms relating to self-regulation (‘executive function’)
What is the diagnostic triad for ADHD?
Inattention
Hyperactivity
Impulsivity
What are some symptoms of ADHD?
Social communication difficulties Learning disability Attachment difficulties Mood and anxiety problems Behavioral disorders (OCD/CD) Substance use
How do you diagnose ADHD?
Difficult to diagnose- very subjective
History and examination
How is memory affected in ADHD?
Working memory in children with untreated ADHD resembles that of elderly with Alzheimer’s
How does ADHD progress?
Some will grow out of it
What is the first line treatment for ADHD?
Stimulants. Improve dopaminergic neurotransmission in networks involved in executive functioning
What are some examples of the first line treatment for ADHD?
Methylphenidate
Dexamfetamine
Lisdexamfetamine
What are some side effects of the first line treatment for ADHD?
Appetite and sleep reduction
What is the second line treatment for ADHD?
Atomoxetine
What are some third line treatment for ADHD?
Antidepressants
Antihypertensives
Antipsychotics
Is ADHD developmental or acquired?
Developmental therefore there at early age, not acquired, but becomes more prominent as age.
In what settings is ADHD present?
All settings. If only in one, eg school, think bullying or such like.
What emotional problem can ADHD often cause?
Low self esteem
What are some complications of ADHD in children?
- Increased level of home stress and high expressed emotions
- Emotional dysregulation leads to difficulties in peer relationships and reckless and dangerous behaviour
- Poor problem solving ability leading to developmentally inappropriate decision making
- Significant barrier to learning and potentially exclusion from education
- Higher likelihood of antisocial behaviours
What are some complications of ADHD in adults?
- Higher levels of criminality, antisocial behaviour
- Higher level of substance misuse (self-medication?)
- Significant impairments in occupational function that could easily be accommodated for if diagnosis known
What are some perinatal risk factors for ADHD?
- Tobacco and alcohol use during pregnancy
- Foetal Alcohol Syndrome and use of other illicit substances
- Significant prematurity and perinatal hypoxia
- Unusually short or long labour, foetal distress, low forceps delivery and eclampsia
What part of the brain does not work well in ADHD?
Frontal lobe
What is the patho of ADHD?
Upreg of DA removal system therefore excessive reward seeking behaviour.
Serotonin also plays a role.
What are the diagnostic criteria for ADHD in children?
6 or more symptoms of inattentiveness; and/or
6 or more symptoms of hyperactivity and impulsiveness
Symptoms get in the way of life
What are the diagnostic criteria for ADHD in adults?
5 or more of the symptoms of inattentiveness; and or
5 or more of hyperactivity and impulsiveness
Historical concerns since early age
What areas of life should ADHD interfere with in an adult for diagnosis?
Underachieving at work or in education
Driving dangerously
Difficulty making or keeping friends
Difficulty in relationships with partners
What kind of drugs are first line ADHD treatment?
Stimulants
What kind of drugs are second line ADHD treatment?
SNRI
What non-pharma managements are there of ADHD?
Social skill training
Behavioral strategies
How does Methylphenidate work?
Blocks DA reuptake/transport
How does Dexamphetamine work?
Blocks DA reuptake/transport
Increases extracellular norepinephrine andpossibly serotonin
