Psychiatric Disorders Across the Lifecourse

Question 1

What is the DSM-5 criteria for Attention Deficit Hyperactivity Disorder (ADHD) in terms of time and presence of symptoms (6)?

Answer 1

• Present for at least 6 months
• Persistent pattern of inattention and/or hyperactivity – impulsivity
• Inappropriate for their developmental level
• Interferes with functioning or development
• Several symptoms present before age 12
• Several symptoms present in two or more settings
• The symptoms are not better explained by another mental disorder

Question 2

What are the genetic risk factors of Attention Deficit Hyperactivity Disorder (ADHD) (4)?

Answer 2

• No isolated gene for ADHD, there may be several genes contributing to the vulnerability for developing it
• Twin studies have shown a significant heritability for ADHD - as high as 76%
• First degree relatives of children with ADHD have an ADHD diagnostic probability 4-5 times higher than the general population
• Boys are more vulnerable than girls

Question 3

What are the envirnmental risk factors of Attention Deficit Hyperactivity Disorder (ADHD) (3)?

Answer 3

• Premature birth
• Low birth weight
• Prenatal tobacco exposure

Question 4

What is the prognosis of early onset attention defecit hyperactivity disorder (ADHD)?

Answer 4

• 70% of children who have this disorder will have the disorder as teenagers
• 40%-60% will still have it as adults

Question 5

What is dementia?

Answer 5

• Degenerative disease of the brain with:
  
  • Cognitive and behavioural impairment
  • Sufficiently severe to interfere significantly with social and occupational function

Question 6

What are the early symptoms of dementia (5)?

Answer 6

• Absent - mindedness
• Difficulty recalling names and words
• Difficulty learning new information
• Disorientation in unfamiliar surroundings
• Reduced social engagement

Question 7

What are the symptoms of a progressed dementia (6)?

Answer 7

• Marked memory impairment
• Reduced vocabulary
• Loss of less complex speech patterns
• Mood swings and / or apathy
• Decline in ADL’s & social skills
• Emergence of psychotic phenomena

Question 8

What are the specific symptoms of advanced Alzheimer’s Disease (AD) (5)?

Answer 8

• Monosyllabic speech
• Psychotic symptoms
• Behavioural disturbance
• Loss of bladder and bowel control
• Reduced mobility

Question 9

What are the psychiatric symptoms of dementia (3)?

Answer 9

• Delusions (15%) - usually of a paranoid nature
• Auditory and / or visual hallucinations (10–15%) - which may be simple misidentification, and indicate rapid cognitive decline
• Depression is common, requiring treatment in up to 20% of patients

Question 10

What are the behavioural disturbances in patients with dementia (7)?

Answer 10

• Aggression
• Wandering
• Explosive temper
• Sexual disinhibition
• Incontinence
• Excessive eating
• Searching behaviour

Question 11

How does the personality of dementia patients change?

Answer 11

• Often reflects an exaggeration of premorbid traits with coarsening of affect & egocentricity

Question 12

How is dementia diagnosed?

Answer 12

• Mini Mental State Examination (MMSE)
  
  • 25-30: Normal
  • 21-24: Mild impairment
  • 10-20: Moderate impairment
  • <10: Severe impairment