MS PEDIA - ODD, CD, ADHD

3 years old

ODD can begin as early as this age

8 years old and not later than early adolescence

ODD is typically noted by this age

1-11%

ODD prevalence

3.3%

Average prevalence of ODD

1.4:1

ODD ratio males:females

12 years old and up

Prevalence of ODD diminishes in youth this age

18-24 months

ODD is normal at this age in children

angry/irritable, argumentative/defiant, vindictive

Three types of ODD

1, usually the home

Symptoms of ODD is confined to this many settings

cortisol

Stress hormone

skin conductance reactivity

Arousal/reactivity to stressful events

6

Patterns in ODD should last for at least _ months

4 symptoms

Number of ODD symptoms to be diagnosed

twice within the past 6 months

Vindictiveness should happen at least ____ to be diagnosed with ODD

on most days for at least 6 months

For children younger than 5 years, ODD behavior should occur this much

at least once per week for at least 6 months

For individuals older than 5 years, behavior should occur this much

mild ODD

ODD symptoms confined to only one setting

moderate ODD

ODD symptoms confined in at least two settings

severe ODD

ODD symptoms confined in three or more settings

mood disorder

Diagnosis where irritability is episodic

disruptive mood disregulation disorder

Diagnosis where there are chronic temper outbursts and negative mood is more severe

25%

% of children that lose ODD symptoms or improve to non-clinical levels

individual psychotherapy

Treatment for ODD where roleplay and practice for adaptive responses occur

2 to more than 10%, median of 4%

CD prevalence

4-12:1

CD ratio males:females

plasma dopamine-hydroxylase

Enzyme that converts dopamine to norepinephrine

5-HIAA

Blood serotonin levels correlate inversely with levels of this substance in the CSF

aggression and violence

5-HIAA correlates with these characteristics in CD

middle childhood through middle adolescence

Onset of significant symptoms of CD occur during

10-12 years old

Average onset of CD in boys (meeting the diagnostic criteria)

14-16 years old

Average onset of CD in girls (meeting the diagnostic criteria)

3 out of 15 in the past 12 months; 1 in the past 6 months

Number of CD symptoms to be diagnosed and period

6

1 criterion in CD symptoms should be present within the past _ months

childhood-onset type

Individuals show at least one CD symptom prior to age 10

adolescent-onset type

Individuals show no CD symptom prior to age 10

unspecified onset

Diagnosis for CD are met but not enough information regarding onset of first symptom

limited prosocial emotions

Specifier that requires display of at least two CD characteristics over at least 12 months in multiple relationships and settings

lack of remorse/guilt, callous, unconcerned about performance, and shallow or deficient affect

Characteristics to be considered for limited prosocial emotions

mild CD

CD problems are few and cause minor harm to others

moderate CD

Number and effect of CD problems are intermediate

severe CD

Many CD problems and cause considerable harm to others

Intermittent explosive disorder

Diagnosis of impulsive aggression that is not premeditated or committed to achieve a tangible objective

adjustment disorder

Diagnosis characterized by disturbance in conduct with psychosocial stressor

6

In adjustment disorder, symptoms typically resolve within _ months after termination of stressor

aripiprazole and risperidone

Atypical antipsychotics for treatment of CD

sedation, increased prolactin levels, and extrapyramidal symptoms (akithisia)

Side effects of second-generation antipsychotics

clonidine

CD treatment that decreases aggression as it inhibits norepinephrine

SSRIs

CD treatment that target symptoms of impulsivity, irritability, and mood lability

15%

ADHD % with purely inattention deficits

5%

ADHD % with purely hyperactivity-impulsivity deficits

80%

ADHD % with both inattention and hyperactivity-impulsivity deficits

hyperactive syndrome

Term for ADHD in the early 1900s

minimal brain damage

Term for ADHD in the 1960s

ADHD

Most common chronic behavioral disorder in children

3-5%

ADHD prevalence worldwide in school-aged children

2.5%

ADHD prevalence worldwide in adults

2-8x greater

Rate of ADHD in children with parents and siblings with ADHD

4.6 to 7.6

First-degree relatives are at a ___-fold risk of developing ADHD

D4 (DRD4)

Dopamine receptor

11p15.5

Chromosome where DRD4 is located

DAT1

Dopamine transporter

locus ceruleus

Brain region where noradrenergic neurons are located

1500g

Very low birth weight of ___ is a risk factor for ADHD

dopamine deficiency

Postulated to account for the lack of impulse control in ADHD

7 years old

ADHD signs begin before this age

at least 6 months

ADHD signs should persist for this long

two or more

ADHD signs should persist in this many settings

2 years old

Earliest age when ADHD symptoms can be detected

3 to 5 years

Peak time of onset of ADHD symptoms

at least 6 symptoms

Diagnosis of ADHD requires this many symptoms for inattention and/or hyperactivity

at least 5 symptoms

If individual is 17 or older, this many symptoms are required for ADHD for inattention and/or hyperactivity

12 years old

Several ADHD symptoms should be present before this age

combined presentation

If inattention and hyperactivity-impulsivity symptoms are met for the past 6 months in diagnosis of ADHD

predominantly inattentive presentation

If ONLY inattention symptoms are met for the past 6 months in diagnosis of ADHD

predominantly hyperactive/impulsive presentation

If ONLY hyperactive-impulsivity symptoms are met for the past 6 months in diagnosis of ADHD

partial remission

Specifier where full ADHD criteria were previously met, fewer in the past 6 months, and symptoms still result in impairment

mild ADHD

Few ADHD symptoms and result in no more than minor impairments

moderate ADHD

ADHD symptoms between "mild" and "severe"

severe ADHD

Many ADHD symptoms or several severe symptoms and result in marked impairments

60-85%

% of cases wherein ADHD symptoms persist into adolescence

60%

% of cases wherein ADHD symptoms persist into adulthood

40%

% of cases wherein ADHD symptoms remit at puberty or in early adulthood

12-20 years old

Remission of ADHD symptoms often occur between these ages

reactive attachment disorder

Diagnosis of inattention/impulsivity but stems from trauma and with attachment issues

substance use disorder

Diagnosis of restlessness and poor focus but is caused by substance effects/withdrawal

psychotic disorder

Diagnosis of inattention and hyperactivity that occur exclusively during psychotic breaks

Syndenhams chorea

Jerky, uncontrollable movement disorder due to an infection (bacteria)

half of children with combined presentation, quarter with inattentive presentation

ODD co-occurrence with ADHD

quarter of children/adolescents with combined presentation

CD co-occurrence with ADHD

petit mal epilepsy

Seizure characterized by brief lapses of consciousness that produce similar symptoms to ADHD

methylphenidate

Stimulant for ADHD that inhibits receptor uptake of dopamine by blocking DAT1

10 to 50 mg per day

Methylphenidate optimal doses

ritalin sustained release

Long-acting methylphenidate preparations

6 hours

Hours where ritalin sustained release is effective

concerta, ritalin-la, and metadate CD

Brands of long-acting methylphenidate preparations

8 to 12 hours

Duration of action of concerta, ritalin-la, and metadate CD

Modafinil

Stimulant that was developed for narcolepsy but failed to be FDA approved due to Steven-Johnson Skin Rash as a side-effect

Pemoline

Stimulant that enhances dopamine activity but with risk of liver toxicity

Clonidine AE

Alternative medication for ADHD but with cardiovascular complications as a side effect

Guanfacine

Alternative medication for ADHD but is less sedating and less apt to cause hypotension and with a longer half-life