Which one of the following is indicated in the routine diagnostic workup for attention-deficit/hyper-activity disorder (ADHD)?
Correct Answer E:
The use of rating scales and/or questionnaires has been integral to the diagnosis of attention-deficit/hyperactivity disorder (ADHD). Continuous performance testing is designed to obtain samples of the child’s behaviour, but the sensitivity and specificity are too low to be useful at this time. Likewise, thyroid testing, EEGs, and blood lead levels are not indicated in the routine workup for ADHD.
Compared to children with attention-deficit/hyperactivity disorder (ADHD), adults with ADHD:
Correct Answer B:
Longitudinal studies of young people diagnosed with attention-deficit/hyperactivity disorder (ADHD) show that symptoms of hyperactivity and impulsivity may decrease with age, but inattention tends to persist. Studies of clinically referred adults with ADHD show that about half have clinically important levels of hyperactivity and impulsivity and up to 90% have prominent intentional symptoms. Like some youth with ADHD, adults with ADHD tend to have additional cognitive deficits, specifically executive function deficits, which include problems encoding and manipulating information and difficulties with organization and time management.
Research shows that using retrospective self-reports of adults is a valid method of diagnosing ADHD. Studies have shown that the consistent reporting of childhood ADHD symptoms by both adults and their parents is highly correlated. Research has also found strong agreement between the self-reports of adults and their partners regarding ADHD symptoms.
Regarding the epidemiology of attention deficit hyperactivity disorder (ADHD) all of the following are true, except:
ADHD is far more common in boys than girls, with a sex ratio of approximately 3:1. Although prevalence rates can be affected by changing the threshold number and severity of symptoms, most experts agree on the 3-5% range. Comorbid psychiatric conditions may include conduct, oppositional, and anxiety disorders. Half of Tourette’s patients have comorbid ADHD which usually precedes the tics. Many with ADHD later develop alcohol and drug problems.
Which of the following could be associated with attention deficit hyperactivity disorder (ADHD)?
In addition to the primary symptoms of inattention, hyperactivity, and impulsivity, ADHD can cause secondary problems. Poor attention to social cues can cause a child to be unpopular and rejected by peers. Parental frustration in repeatedly disciplining the child can result in abuse. Hyperactivity combined with impulsiveness and inattention to danger and warnings makes children with ADHD accident-prone. The adult outcome of ADHD is variable. At least one third are not significantly different in adulthood from a matched normal control group.
A 12-year-old boy is brought to the physician because of a pattern of behavior that has been worsening over the past year. His mother states that he has been bullying other boys at school, staying out late without permission, setting small fires in abandoned lots, and physically abusing neighborhood cats. During the examination, a speculum from the examination room drawer falls out from underneath his shirt.
Which of the following is the most likely diagnosis?
Correct Answer C:
This patient has conduct disorder. The diagnosis requires a pattern of behavior that violates societal rules and the basic rights of others. Common features include lying, stealing, running away, staying out without permission, setting fires, truancy, vandalism, cruelty to animals, bullying, physical aggression, and sexual aggression. At least three of these features must be present to make the diagnosis. Twenty-five to fifty percent of these patients go on to have antisocial personality disorder as an adult.
Click to expand