Conduct disorders

Question 1

ADHD
Dx:
Tx:

Answer 1

Dx:

• Sx of hyperactivity/impulsivity or inattentiveness leading to impairment
• Onset MUST be before 12y/o and present for at least 6 month
• Must occur in at least 2 settings (school, home, recreational)

Tx:
Behavioral modification
Stimulants 
-Methylphenidate, adderall, Focalin 
Non-stimulants 
-Atomoxetine (Strattera)
Adjunctive meds 
-Bupropion 
-Venlafaxine
-Guanfacine
-Clonidine

Question 2

Autism Spectrum d/o
Path
Dx
Tx

Answer 2

Path:

• Prenatal viral exposure
• Immune system abnormalities
• Genetic factors

Dx:
Primary
-Social interaction difficulties (avoiding eye contact, no response to cuddling or affection)
-Impaired communication (metaphors, humor in jokes)
-Restricted, repetitive, stereotyped behaviors
Other signs: persistent failure to develop social relationships, failure to show preference to parents over other adults, unusual sensitivity to visual, auditory or olfactory stimuli
Male : female 4:1

Tx:

• Referral for neuropsychological testing
• Behavioral modification strategies
• Medications

Question 3

Conduct d/o
Path
Pt
Dx
Tx

Answer 3

Path: More severe sx than oppositional defiant disorder

Pt:

• Pediatric version of antisocial personality disorder
• Frequent fighting, truancy, theft, discrediting those w/ concerns about their behaviors
• Cruelty to animals or people, destroy property, intimidate others, generally shows no remorse
• Males, childhood/early adolescent

Dx:
Different from oppositional defiant disorder b/c conduct disorder involves aggression towards people or animals

Tx:
Meds not generally prescribed
-Antipsychotics (risperidone, quetiapine) for severe aggression
-Mood stabilizers, SSRIs if antipsychotic not effective

Question 4

Oppositional defiant d/o
Pt
Dx
Tx

Answer 4

Pt:

• Recurrent angry/irritable mood, argumentative/defiant behavior or vindictiveness
• High association with ADHD
• Often seen it when child is treated with harsh, inconsistent parenting

Dx: Behavior lasting at least 6 months
At least 4 sx
-Temper
-Argues w/ adults
-Defies or refuses to comply 
-Blames others
-Angry and resentful
-Spiteful or vindictive 

Tx: Psychotherapy
Parent management therapy involves training parents to change their own behaviors which will help alter their children’s problem behavior