Child and Adolescent Psychiatry Flashcards
Symptoms required for diagnosis of ADHD in children?
Persistent pattern of inattention symptoms or a combination of hyperactivity and impulsivity symptoms
Symptoms <12 yrs
Range of environments/settings e.g. school, home, with friends, with relatives etc.
What are some of the symptoms seen in children with ADHD?
Unable to sit in seat
Talkative
Blurts answers out
Difficulty engaging quietly in activities
Interrupts
Acts without consideration of consequence
Management of children with ADHD?
School adjustments
Repair relationships- educating and supporting parents
Medications:
Methylphenidate 1st line
Lisdexamfetamine 2nd Line
Atomoxetine/Guanfacine 3rd line
->according to SIGN guidelinds, either 1st or 2nd line or work well, they are both stimulants.
Side effects of Methylphenidate?
Poor appetite- will often not eat much at school and come home ravenous
What are motor/phonic tics?
Brief repetitive patterned and non rhythmic movements or vocalisations sometimes performed in response to premonitory urges
Give examples of simple tics.
Blinking, grunting
Give examples of complex tics.
Gestures, words and phrases
Which type of tics are seen in Tourette’s syndrome?
Motor and phonic tics
When does Tourette’s occur?
Onset in developmental period 4-6yrs, peak at 8-12yrs.
When may tics in Tourette’s diminish?
During sleep
During enjoyed activites
What worsens tics seen in Tourette’s?
Stress
How is an assessment of tics carried out?
History
Examination normal
Yale Global Tic Severity Scale
Investigations not required.
Management of tics?
Education for patient and family
If tics are severe, can be referred to neuro
Medical treatment of tics?
Not usually required.
Alpha-2-adrengeric agonists e.g. Clondine
Atypical antipsychotics
