Questions and Answers-cont.
Page 1
When is "inattentiveness" an "attention deficit disorder?"
When is hyperactivity abnormal?
Are girls with ADHD more prone to learning impairments than boys?
Page 2
Does fetal exposure to alcohol, marijuana, or cigarettes increase the risk of ADHD?
Are PCBs and other environmental toxins potential causes of ADHD?
Page 3
What is oppositional defiant disorder?
How is a conduct disorder defined?
How are mood disorders recognized?
Page 4
What are the principal forms of therapy of ADHD?
What are the roles of the psychologist and psychiatrist in the management of the child with ADHD?
Why are motivational techniques emphasized in parent counseling and training sessions?
Page 5
What types of special education placements are available for children with ADHD in public schools?
What are some of the professional support services available in public schools?
Can I expect my child to outgrow the ADHD?
Psychiatric disorders sometimes associated with ADHD include oppositional defiant disorder, conduct disorder, mood disorders, and anxiety disorders, including obsessive compulsive disorder. These are referred to as comorbid disorders. They complicate the management of ADHD, and if severe enough to impair school and social functioning, will require psychiatric or psychological intervention. For practical purposes, the following definitions are simplified from the DSM-IV diagnostic criteria.
Q:What is oppositional defiant disorder?
A: The criteria for the diagnosis of oppositional defiant disorder include at least five of the following, present for at least six months:
- Loses temper often
- Argues with adults
- Refuses to do chores
- Annoys other people
- Blames others
- Easily annoyed
- Often angry
- Often spiteful
- Swears frequently
Q: How is a conduct disorder defined?
A: A conduct disorder is significant if at least three of the following criteria have been present for at least six months:
- Steals
- Runs away from home
- Lies
- Sets fires
- Plays truant
- Breaks into someones house, building, or car
- Destroys others property
- Cruel to animals and/or people
- Sexually abusive
- Starts fights, with or without a weapon
Q: How are mood disorders recognized?
A: Mood disorders include manic and/or depressive episodes, bipolar disorders, cyclothymia, and dysthymai.
A manic episode consists of elevated or irritable mood sufficient to impair school and social functioning and associated with at least three of the following:
- Heightened self-esteem
- Sleeplessness
- Excessive talking
- Flight of ideas
- Distractibility
- Excessive goal directed activity
- Excessive spending and buying sprees
A depressive episode is recognized by at least five of the following symptoms, persisting for at least two weeks, and one consisting of either depressed mood or loss of interest in activities:
- Depressed mood
- Loss of interest in activities
- Loss or abnormal increase in weight
- Inability to sleep or excessive sleepiness
- Restless or sluggish
- Excessive fatigue
- Guilt feelings
- Inability to think or concentrate
- Thoughts of death or suicide
Bipolar disorders are manic, depressive, or both, with recurring manic or depressive episodes, not necessarily meeting the full criteria for diagnosis.
Cyclothymia is characterized by numerous hypomanic and depressed, but not major, episodes over one year or longer and never without some symptoms for more than two months at a time.
Dysthymia is a depressed or irritable mood occurring daily, without major depression, for at least one year and manifested by at least two of the following:
- Poor or excessive appetite
- Loss of or excess sleep
- Loss of energy or fatigue
- Poor self-esteem
- Inability to focus and concentrate
- Feelings of hopelessness
CopyrightŠ1998 J. Gordon Millichap,M.D., F.R.C.P.,Editor
All Rights Reserved
 
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