Behavioral Health Flashcards
Ratio of boys to girls with ADHD (both disorders):
- Hyperactive: Boys x4 more
- Inattentive: Boys x2 more
Neurodevelopmental factor of ADHD:
Imbalance between NE and DA in the prefrontal cortex
ADHD heredibility is:
Higher than that of cancer and heart disease
What are some dietary influences on ADHD?
- Red food dye
- Refined sugar
- Fatty acid deficiency
- Iron and zinc deficiency
What are some exposures that can contribute to ADHD?
- Cigarette smoke and alcohol
- Low birth weight
- Head injury
What are the three forms of ADHD?
- Hyperactive: can’t sit still
- Inattentive: off task
- Combined: all the above
To diagnose kids with ADHD what are the DSM-5 criteria for both over the age of 17 and under?
<17: 6 or more symptoms
>17 or 17: 5 or more symptoms
The symptoms to diagnose ADHD must (5):
- Occur often
- Be in more than one setting
- Present before the age of 12
- Impair function
- Be excessive for the development of the child
What three systems should you focus on for ADHD ROS?
- Cardiac
- Neuro
- Psych
- *look for marfan’s as well
What is the problem with ADHD stimulants and cardiac?
There is increased risk of sudden cardiac death taking stimulants
If you are going to put a kid with risk factors for cardiac problems on a stimulant you must:
ECG full work up or referral to cardiac consult
What two things do stimulants do to the heart?
Increase the HR and BP
What are two drugs that can cause CV side effects?
- Albuterol
- Pseudoephedrine
What are the two most common ADHD rating scales? They are NOT __
- Connors
- Vanderbilt Assessment scale
- *not diagnostic
What are 5 other tests you should do on a kid that may have ADHD?
- Speech and path
- Blood lead level
- Thyroud
- OSA
- Neuro problems - absence seizures
What other disorder exists 50-80% of the time with ADHD?
Oppositional Defiant Disorder
What exists 33% of the time with ADHD (2)?
- Depression
- Conduct disorder
What is worse, ODD or conduct?
Conduct - lying, theft, violation of laws, threatening, aggressive
Refusing to go to school is a sign of:
Seperational anxiety
What kids are at a higher risk for depression?
Those with attentional, learning, conduct or anxiety disorders.
What is the initial therapy for a kid with ADHD that is school aged?
- Behavioral management
- Educational intervention
- Pharmacotherapy
What is the initial therapy for a kid that is preschool aged?
Behavioral therapy - do not want to medicate them until they are school aged
What is the most effective for treating ADHD?
Psychostimulants with or without behavioral therapy
What are three SE of psychostimulants?
Anorexia, insomnia, tics
What are the three amphetamine stimulants for ADHD?
- Adderall
- Vyvanse
- Dexedrine
What are the four Methylpenidate stimulants for ADHD?
- Ritalin
- Focalin
- Methylin
- Concerta
What are the lengths of efficacy for stimulants?
Short: 3-6 hours
Intermediate: 6-8
Long: 10 - 12+
How should you start a kid on a stimulant?
In the summer/at home on break at a low dose and titrate up (3-7 day basis)
What is the percentage improvement with ADHD medications?
70%
What type of ADHD is a Drug Holiday most beneficial for?
Inattentive type
What is a non-stimulant medication for ADHD?
Atomoxetine - Increases NE in the brain
You cannot do what with a non-sitmulant
Take a drug holiday!!!
What is second-line non stimulant for ADHD?
Alpha agonist: Clonidine, Guanfacine
What is the most common SE for an alpha agonist for ADHD?
Sleepiness and sedation (good for a kid with insomnia)
How many kids with ADHD become adults with ADHD?
2/3rds
What are the two major areas of deficit when someone has Autism?
- Deficits in social communication
- Restricted repetitive patterns
Boys are ___ more likely to have autism than girls.
4x
Loss of developmental milestones when a child has autism occurs at:
12-15 months
When do you screen for autism?
18 and 24 - Early diagnosis is critical!
__ percent of HS students have drank
70%
What age group is exposed to their parents using:
12-14
Sons of male alcoholics are __ times more likely to become alcoholics
9x
What is the goal for a substance case?
Harm reduction first than the ultimate goal of sobriety!
