ADHD Lecture Powerpoint Flashcards
ADHD is present in approx __% of children, __% of adults, more common in ___ gender, majority have ___ disorders
5%, 2.5%, males, comorbid
Characteristics of adult ADHD patients (3)
- less likely to have college degree
- more likely to be divorced
- more likely to be unemployed
ADHD pathophysiology
Exact etiology of ADHD is unknown but multiple genetic factors have been implicated, 50% of children have parents who have the disorder,often see right prefrontal cortex/caudate nucleus/globus pallidus are smaller suggesting lack of connectivity of regions of brain that modulate attention and impulsivity
2 neurotransmitters implicated in ADHD
Dopamine
Norepi
Potential environmental influences on ADHD (4)
- Dietary influences controversial (red dye, FDA says no but can’t hurt if patients want to try)
- prenatal to alcohol, smoking, valproate
- head trauma
- foster care
Core 3 symptoms of ADHD
Hyperactivity
Impulsivity
Inattention
Inattentive symptoms of ADHD
Often has difficulties sustaining tasks and activities, avoids tasks that require sustained mental effort, easily distracted at a level inconsistent with developmental level
Hyperactivity symptoms of ADHD
Fidgeting or tapping hands or feet, leaving seat in classroom, difficulty waiting turn
Adult signs and symptoms of ADHD
-Socially inappropriate, start on projects without reading or listening to instructions, tend to speed while driving, frequently forget appointments
ADHD diagnostic criteria
Persistent pattern of inattention and or hyperactivity/impulsivity that interfere with functioning or development, typically some symptoms before age of 12* in 2 or more settings** that is not explained by other disorders (substance abuse in teens for example)
3 subtypes of ADHD
- Predominantly inattentive (more common older)
- Predominantly hyperactive impulsive (more common younger)
- Combined
ADHD diagnostic workup
- Lab tests and neurological testing not needed except for differential
- Standardized behavior rating scale
- Very thorough evaluation about history
- physical exam usually normal unless something on differential
2 types of validated behavioral rating scales for children, which 2 individuals are best to complete it?
- Broadband scale (assess variety of behavioral symptoms not limited to ADHD but including it, useful for narrowing differential)
- ADHD specific scales (narrow band scales)
- parent and teacher
Validated behavioral rating scales for adults
-Not used alone for diagnostic purposes, have to use screening tools to narrow out variety of other conditions
ADHD treatment options (3)
- Environmental restructuring
- behavioral therapy AND
- combined medication (if above preschool age
