PEDS Flashcards
what is the most commonly dx MH disorder in childhood?
ADHD
what are core symptoms of ADHD?
inattention, inability to self-regulate, hyperactivity, and impulsivity that do not correspond to chronological age. Education can be severely affected as can social relationships both at home and at school. Self-efficacy and self-esteem issues often ensue. It affects children of a all intellects.
What are the key diagnostic criteria for Attention Deficit Hyperactivity Disorder (ADHD) in children and teens?
Symptoms:
Inattention: 6 or more symptoms (5 for teens).
Hyperactivity/Impulsivity: 6 or more symptoms (5 for teens).
Onset: Symptoms present before age 12 and lasting for over 6 months.
Settings: Impairment in more than one setting (e.g., school, home, work).
Significant Impairment: Clinically significant impairment not better explained by another disorder.
what is distractibility?
Inability to focus attention for age-appropriate periods of time.
what is Hyperactivity?
Excessive activity significantly above the level expected for the setting and the individual’s developmental age
what is impulsivity?
Acting without appropriate thought or consideration, often leading to dangerous situations.
What are the indications for starting ADHD medication?
egin medication when ADHD symptoms cause significant impairment in daily functioning
what are S/E of stimulants?
Common side effects: appetite suppression, sleep disturbances, anxiety, and increased heart rate.
Dextroamphetamine and Amphetamine (Adderall)
Q: What is the indication, half-life, and common side effects?
Indication: ADHD
Half-Life: 10 hours
Side Effects: Nervousness, restlessness, difficulty sleeping
Comments: May slow children’s growth or weight gain; may be addictive.
Dextroamphetamine (Dexedrine)
Q: What is the indication, half-life, and common side effects?
Indication: ADHD, narcolepsy
Half-Life: 2-3 hours
Side Effects: Nervousness, restlessness, difficulty sleeping
Comments: May be addictive.
Methylphenidate (Ritalin, Concerta)
Q: What is the indication, half-life, and common side effects?
Indication: ADHD, narcolepsy
Half-Life: 2-3 hours
Side Effects: Nervousness, restlessness, difficulty sleeping
Comments: May be addictive.
Lisdexamfetamine (Vyvanse)
Q: What is the indication, half-life, and common side effects?
Indication: ADHD
Half-Life: 10-13 hours
Side Effects: Decreased appetite, weight loss, trouble sleeping, nervousness
Comments: May be addictive.
Atomoxetine (Strattera)
Q: What is the indication, half-life, and common side effects?
Indication: ADHD
Half-Life: 5.2 hours
Side Effects: Nausea, dry mouth, appetite loss, insomnia, fatigue, headache, cough
Comments: A selective norepinephrine reuptake inhibitor (SNRI). No abuse potential.
What is Oppositional Defiant Disorder (ODD)?
A conduct disorder characterized by defiance, losing temper, arguing with authority, defying rules, and being resentful or spiteful.
At what age can ODD begin?
ODD can begin as early as the preschool years, not after early adolescence. it is more common in males than females.
What are the significant impairments caused by ODD?
Impairments in emotional, social, academic, and occupational adjustment.
What are the three main risk factors for developing ODD?
1) Personality/temperament with high emotional reactivity and low frustration tolerance.
2) Harsh, inconsistent, or neglectful parenting.
3) Genetics and neurobiology, including abnormalities in the prefrontal cortex and amygdala.
What specific behaviors are associated with ODD?
Losing temper, arguing with adults, purposely annoying others, blaming others for mistakes, and being angry or resentful.
What common comorbidity is often associated with ODD?
ADHD
What increased risk is associated with ODD, even when controlling for comorbid disorders?
Increased risk for suicide attempts.
Why is it important to differentiate ODD from inattention problems?
Purposely failing to obey authority must be separated from problems of inattention.
What defines conduct disorders, which are more severe than ODD?
A pattern of aggression toward people or animals, destruction of property, or theft/deceit for at least six months.
What are some symptoms of antisocial personality disorder?
Disregard for others’ rights, deceitfulness, impulsivity, irritability, aggressiveness, reckless disregard for safety, irresponsibility, and lack of remorse.
What is required for a diagnosis of antisocial personality disorder?
The individual must be at least 18 years old and have a history of conduct disorder.
How many symptoms must be present from the specified categories for a diagnosis of ODD?
at least 4
What is the minimum duration for the pattern of behaviors to be diagnosed as ODD?
at least 6 months
What underlying issues may contribute to ODD and related disorders?
Child abuse, neglect, or sexual abuse.
What should be considered when assessing the behaviors for ODD?
Frequency or intensity compared to normative behaviors for the individual’s development level, gender, and culture
How must the disturbance in behavior impact the individual
It must be associated with distress in the individual or others in their immediate social context or negatively impact important areas of functioning.
Diagnostic Criteria from the DSM-5 ODD
A pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during an interaction with at least one individual who is not a sibling.
Angry/Irritable Mood
Often loses temper
Is often touchy or easily annoyed
Is often angry and resentful
Argumentative/ Defiant Behaviour
Often argues with authority figures or, for children and adolescence, with adults.
Often actively defies or refuses to comply with requests from authority figures or with rules.
Often deliberately annoy others
Often blames others for his or her mistakes.
Angry/Irritable MoodVindictiveness
Has been spiteful or vindictive at least twice in the past 6 months.
Note: Consideration must be given as to whether the frequency or intensity of the behaviours are outside the range of what is normative for the individual’s development level, gender and culture.
The disturbance in behaviour is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or impacts negatively on social, educational, occupational, or other important areas of functioning.
The behaviours do not occur exclusively during a psychotic episode, substance use, depressive or bipolar disorder.
What is the treatment for ODD?
Parenting training, and the treatment of any comorbidity like ADHD
The main difference between the symptoms of ODD and conduct disorder is ….?
the degree of harm done to others and property
How does early childhood trauma affect the risk of developing major depressive disorder (MDD)?
Early childhood trauma or neglect can set the stage for the development of MDD.
What familial risk factors increase the likelihood of depression and anxiety in children?
Having relatives with depression, anxiety, or other mood disorders.
Which chronic diseases can predispose children and adolescents to MDD?
Epilepsy, Type 1 Diabetes, sleep disorders, eating disorders, metabolic diseases, inflammatory bowel disease, and obesity.
How can a parental interview contribute to the screening for depression and anxiety in children?
It provides contextual insights, developmental history, behavioral observations, and understanding of family dynamics.
What insights can parents provide regarding a child’s emotional state?
They can reveal patterns of behavior at home, changes in mood, sleep patterns, and appetite.
What are the key criteria for diagnosing Major Depressive Disorder (MDD) in children?
Anhedonia or depressed mood for at least 2 weeks, a change in previous functioning, and symptoms causing considerable distress and impairment.
What additional symptoms may be present in adolescents with MDD?
Impulsivity, fatigue, hopelessness, antisocial behavior, substance use, restlessness, aggression, and problems with family or school.
How do symptoms of MDD differ in school-aged children?
They may present with irritability, anger, externalizing behaviors, school avoidance, and internalizing symptoms like social withdrawal or somatic complaints.