Pediatric Psych Flashcards
Manifests in childhood with symptoms of hyperactivity, impulsivity, and/or inattention. affect cognitive, academic, behavioral, emotional, and social functioning
ADHD
A genetic imbalance of catecholamine metabolism in the cerebral cortex appears to play a primary role
pathogenesis of ADHD
Cerebral structural and functional abnormalities in prefrontal structures and basal ganglia regions. Results in impaired executive fxns
ADHD
Criteria for ADHD diagnosis
present in more than one setting for at least 6 months and before 12 yrs old.
Two categories of core ADHD sx
Hyperactivity/impulsivity and Inattention
Sx include: excessive fidgetiness, difficulty remaining seated, feelings of restlessness, difficulty playing quietly
hyperactivity
Sx include: excessive talking, difficulty waiting turn, blurting out answers, interruption of others
impulsivity
Sx include: difficulty organizing tasks, avoids tasks that require consistent mental effort, easily distracted, forgetfulness in routine activity
inattention
According to DSM-5 criteria for ADHD diagnosis, how many symptoms of hyperactivity, impulsivity or inattention are needed?
≥6 symptoms for kids. ≥5 for pts older than 17 yrs
Indications for ADHD referral
coexisting psychiatric or neurological disorders and lack of response to stimulant therapy
Broad categories of stimulant medications for ADHD
amphetamines and methylphenidate
Second line agent for ADHD
atomoxetine (Strattera)
Preferred medication for preschool children
methylphenidate. Indicated if failure of behavior tx
Prenatal exposure that may contribute to autism spectrum disorders
Valproic acid or thalidomide
3 main areas of functioning affected by autism spectrum disorders
social interaction, communication, behaviors/interests
mildest form of autism. become obsessively interested in a single object or topic. above average intelligence.
Asperger’s
Between Autism and Asperger’s in terms of severity of symptoms. Symptoms vary widely. Impaired social interaction
Pervasive developmental disorder not otherwise specified (PDD-NOS)
More severe impairments in social fxning, language, repetitive behaviors. Associated with mental retardation and seizures
Autism
screening tool for autism in toddlers and young children
STAT
modified checklist for autism in toddlers
MCHAT
characterized by aggressiveness and purposefully bother/irritate others
oppositional defiant disorder
Negative, manipulative, hostile, and defiant behavior
oppositional defiant disorder
If a parent is alcoholic and has been in trouble with the law, how likely is their child to have ODD?
3x more likely (18%)
Group of behavioral and emotional problems in children
Significant difficulty following rules and behaving in a socially acceptable way
conduct disorder
Differences between conduct disorder and oppositional defiant disorder
Children with ODD seem to have worse social skills than those with CD. Children with ODD seem to do better in school
Most serious psychiatric disorder
conduct disorder
Characterized by aggression to ppl and animals, destruction of property, deceitfulness
conduct disorder
What happens to children with conduct disorder who don’t receive tx?
become adults with antisocial behavior
When does the risk of suicide increase?
increase as the patient recovers some from depression and has more energy and motivation
Name two SSRIs approved for children
fluoxetine (Prozac) 8-17. Escitalopram (Lexapro) 12-17
What drug class does this black box warning go with: Increased suicidality risk in children, adolescents, and young adults w/ major depressive or other psychiatric disorders
SSRIs
What does SIGECAPS stand for?
sleep disturbance, interests, guilt, energy, concentration problems, appetite change, pleasure, suicidal thoughts
