E1: Peds Psych & ADHD Flashcards
What is it called when there is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development?
ADHD
What are the two sub types of ADHD?
Inattention and hyperactivity-impulsivity
What is the diagnostic criteria of ADHD?
A) persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
B) symptoms present prior to age 12
C) symptoms present in 2 or more settings
D) Clear evidence symptoms interfere with or reduce quality of social, academic or occupational functioning
What population is ADHD most common in?
Elementary school aged children
What are the pediatric rating scales for ADHD?
- Vanderbilt assessment scales ( 4 yrs and older)
- Conners comprehensive behavior rating scales
- ADHD rating scale
What are the adult rating scales for ADHD?
- ASRS
- CAAR
These should be completed at time of diagnosis, during medication titration, and at regular medication follow up visits
What is the pathophysiology of ADHD?
1) environment factors (pre, peri, and post natal complications, childhood diseases, trauma, drug exposure)
2) NT alterations (decreased DA and/or NE)
3) Neuroanatomical changes in the circuits (pre-frontal cortex; parietal cortex; striatum;cerebellum)
The targets for neurotransmitters are discrete nuclei that are within what 3 things?
- basal forebrain
- limbic system
- cerebral cortex
Where is NE produced?
The locus Coeruleus
What disorders are associated with NE imbalance?
- Attention Deficit disorders
- Mood disorders (bipolar)
- Anxiety disorders (generalized anxiety and PTSD)
- Drugs of abuse (psychostimulants)
Where is serotonin produced?
The brain stem (raphe nuclei)
What are the targets of serotonin throughout the forebrain)
- Limbic system (mood)
- Cortex and thalamus (Sensation and perception)
- Hypothalamus (circadian rhythms, appetite)
What disorders are associated with serotonin imbalance?
- Mood disorders
- impulse control disorders
- OCD
- Anxiety disorders (social anxiety and generalized anxiety)
- Eating disorders
- drugs of abuse (hallucinogens)
Where is Dopamine produced?
In the midbrain (substantia nigra and VTA)
What are the targets of dopamine throughout the forebrain?
- SN to basal nuclei (motor control)
- VTA to limbic system and cortex (reward, reinforcement, and cognition)
What disorders are associated with dopamine imbalance?
- Psychotic disorders (dysregulation of VTA to cortex/limbic pathways)
- SUD
- Movement disorders (Parkinson’s)
- Cognitive disorders (delirium)
- Mood disorders
Where is ACh produced?
Basal forebrain (Medial septum and nucleus basal is of Meynert)
What are the targets of ACh throughout the forebrain?
- MS to hippocampus (leaning and memory)
- NBM to cortex (attention)
What disorders is ACh associated with?
Dementia and and neurocognitive disorders
Where is glutamate produced?
Throughout the CNS
What disorders are associated with glutamate?
- Psychotic disorders
- Bipolar disorders
- SUD
- Dementia (Alzheimer’s)
What happens to glutamate in Alzheimer’s disease?
A glutamate receptor (NMDA) is hypersensitive to stimulation
How is dopamine related to SUD?
Euphoria due to substances activating the VTA/NAc pathway
Where is GABA produced?
Throughout the CNS (interneurons)
