Psychiatry EOR: Disruptive, Impulse Control and Conduct Disorders; Neurodevelopmental Disorders

Question 1

An 8-year old who is disruptive in class, always fidgeting, has difficulty concentrating and does not complete assignments

What does this patient most likely have?

Answer 1

Attention-deficit/ hyperactivity disorder

Question 2

True or false: To have ADHD symptoms can occur in one setting?

Answer 2

False, they need to occur in more than one setting

Question 3

What is the Tx for ADHD?

Answer 3

methylphenidate first line can also use mixed amphetamine salts

Question 4

How long do symptoms need to occur for ADHD?

Answer 4

6 months or more

Question 5

A child has normal cognitive development, poor relationships and does not spontaneously seek activities with others

What kind of condition does this child likely have or what group of conditions do they fall in?

Answer 5

Autism spectrum disorder

Question 6

If someone has disruption of social interaction and language at age 3 or earlier what kind of condition do they most likely have?

Answer 6

Autistic disorder

Question 7

Autism spectrum disorders encompasses?

Answer 7

1. Autistic disorder
2. Childhood disintegrative disorder
3. Pervasive developmental disorder
4. Asperger disorder

Question 8

What DSM V criteria does the ASD require

Answer 8

1. Social communication and social interaction deficit
2. Restricted and repetitive patterns of behavior
3. hese symptoms must be present in the patient’s early developmental period in the absence of an organic etiology
4. These symptoms cannot be better explained by other conditions

Question 9

Tx for ASD?

Answer 9

1. refer- Autism specialist, speech & language pathologist
2. Audiology evaluation, +/- EEG
3. Behavioral therapy (multisystemic?)

Question 10

What kind of medications are used in the treatment of ASD?

Answer 10

second generation antipsychotics- (risperidone, aripiprazole)

Question 11

If someone has ASD and is in the aggression/hyperactivity or mood liability range what kinds of meds could you use?

Answer 11

Haloperidol, Carbamazepine

Question 12

Say someone with ASD has the stereotyped/repetitive behavior what type of medication can you use to treat this?

Answer 12

SSRI’s

Question 13

A child is referred to your office for unusual animal cruelty and bullying at school

What kind of disorder does this pt have?

Answer 13

Conduct disorder

Question 14

This describes what kind of disorder?

A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated

Answer 14

Conduct disorder

Question 15

How many out of the 15 criteria for conduct disorder does someone need to have? and for how long one?

Answer 15

3 and for the past 12 months

Question 16

What is conduct disorder usually a precursor to?

Answer 16

Antisocial personality disorder

Question 17

What is the minimum age you need to be to be diagnosed with antisocial personality disorder?

Answer 17

18 years old

Question 18

What are some behavioral characteristics associated with conduct disorder?

Answer 18

1. Aggression to people and animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious Violations of rules

Question 19

What is the most effective treatment for someone with conduct disorder

Answer 19

one that seeks to integrate individual, school, and family settings. Treatment should also seek to address familial conflicts such as martial discord or maternal depression

Question 20

A child is found to back talk and resist following instruction from parents or authorities.

What kind of condition does this describe?

Answer 20

oppositional defiant disorder

Question 21

What is the main difference between children with conduct disorder and oppositional defiant disorder?

Answer 21

children with oppositional defiant disorder are not aggressive towards people or animals, do not destroy property, and do not show a pattern of theft or deceit

Question 22

What is the Tx for oppositional defiant disorder?

Answer 22

1. CBT

2. Family therapy

Question 23

What kinds of medications are used for oppositional defiant disorder to control the aspect of ODD?

Answer 23

1. mood stabilizers
2. Antipsychotics
3. stimulants

Question 24

What is a common comorbidity of oppositional defiant disorder?

Answer 24

ADHD, can use haloperidol, thioridazine, and methylphenidate to treat both at the same time.