ADHD

Question 1

Definition of ADHD

Answer 1

Impaired attention

Hyperactivity +/- impulsivity

Question 2

Causes of ADHD

Answer 2

Biological:

• genetic
• low birth weight
• maternal substance use prenatally
• head injury
• metabolic disorders

Psychological:
- prolonged emotional deprivation

Question 3

Gender epidemiology of ADHD

Answer 3

Males > Females

Question 4

Short term complications of ADHD

Answer 4

• insomnia
• low self esteem
• family and peer relationship problems
• reduced academic achievement

Question 5

Long term complications of ADHD

Answer 5

• specific learning disorders such as autism, tics, bipolar
• substance misuse
• reduced employment success
• increased criminal activity
• dis - social personality disorder

Question 6

Symptoms of ADHD

Answer 6

1. Inattention - forgetful, easily distracted, poor organisation
2. Hyperactivity - restless, cannot be quiet
3. Impulsiveness - talks excessively, interrupts others

Symptoms should be evident in more than 1 situation and for at least 6 months

Question 7

Investigations for ADHD

Answer 7

Interview family and child 
Observe child in more than 1 setting 
Collateral information from school 
Rating scales 
Physical examination and neurological examination

Question 8

Management of ADHD

Answer 8

Biological:

• for school aged children - CNS stimulant methylphenidate (Ritalin)
• atomoxetine and dexamfetamine

Psychological:
- psychoeducation

Social:

• behaviour interventions
• school interventions

Question 9

Side effect of methylphenidate

Answer 9

Appetite suppression - can cause growth impairment

Monitor weight