Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-19T02:26:36.948Z Has data issue: false hasContentIssue false
  • English
  • Français

Childhood ADHD & Comorbid Odd: Diagnosis & Contemporary Treatments

Published online by Cambridge University Press:  07 November 2014

Craig L. Donnelly
Get access Rights & Permissions [Opens in a new window]

Extract

Marshall is a 6-year-old child who displayed significant symptoms of hyperactivity, impulsivity, defiance, and temper tantrums since 2 years of age. Marshall lives with his mother, a single parent, and two siblings, ages 4 and 1. His problematic behavior, defiance, and argumentativeness were significant problems at home for his mother, which often made her late to work in the morning. These behaviors were also problematic in the evenings at dinnertime and at bedtime not only for his mother but also for the whole family. Marshall was also having social problems at school including being increasingly shunned by other children because of his aggressiveness and impulsivity as well as being defiant and argumentative with his teachers.

His mother initially sought out her pediatrician, who indicated that Marshall was too young for medication and that better discipline techniques were necessary. Medical workup at that point was unrevealing of any significant condition responsible for Marshall's behavior. Marshall's mother continued to pursue a psychiatric evaluation for Marshall, and a formal psychiatric evaluation revealed diagnoses of attention-deficit/hyperactivity disorder (ADHD), combined type, and oppositional defiant disorder (ODD). Paper and pencil instruments were used including the Swanson, Nolan, and Pelham (SNAP) form for assessing ADHD and ODD symptoms. On the form, both Marshall's mother and teacher indicated that he was significantly elevated in both ADHD and ODD symptom domains, and target symptoms were identified: hyperactivity, impulsivity, short attention span, difficulty with follow through, defiance, argumentativeness, tantrums, and the beginnings of aggressiveness.

Type
Expert Panel Supplement
Information
CNS Spectrums , Volume 14 , Issue S9: The Case for Emerging Therapies in Attention-Deficit/Hyperactivity Disorder , November 2009 , pp. 3 - 6
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Swanson, Nolan, and Pelham (SNAP) Rating Scale. Available at: www.adhd.net. Accessed September 29, 2009.Google Scholar
2.Diagnostic and Statistical Manual of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
3.A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999;56(12):1073–1086.Google Scholar
4.McGough, JJ, Smalley, SL, McCracken, JT et al. , Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry. 2005;162(9):1621–1627.CrossRefGoogle ScholarPubMed
5.Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
6.Maughan, B, Rowe, R, Messer, J, Goodman, R, Meltzer, H. Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry. 2004;45(3):609–621.CrossRefGoogle Scholar
7.Robins, LN, Price, RK. Adult disorders predicted by childhood conduct problems: results from the NIMH Epidemiologic Catchment Area project. Psychiatry. 1991;54(2):116–132.CrossRefGoogle ScholarPubMed
8.Biederman, J, Petty, CR, Dolan, C et al. , The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study. Psychol Med. 2008;38(7):1027–1036.CrossRefGoogle ScholarPubMed
9.Hudziak, JJ, Derks, EM, Althoff, RR, Copeland, W, Boomsma, DI. The genetic and environmental contributions to oppositional defiant behavior: a multi-informant twin study. J Am Acad Child Adolesc Psychiatry. 2005;44(9):907–914.CrossRefGoogle ScholarPubMed
10.Williams, GM, O'Callaghan, M, Najman, JM et al. , Maternal cigarette smoking and child psychiatric morbidity: a longitudinal study. Pediatrics. 1998;102(1):e11.CrossRefGoogle ScholarPubMed
11.Child Behavior Checklist. Available at: www.aseba.org/products/cbc16-/18.html. Accessed September 29, 2009.Google Scholar
12.Conners Rating Scales-Revised (CRS-R). Available at: psychcorp.pearsonassessments.com/HAIWEB/Cultures/en-us/Productdetail.htm?Pid=PAg116. Accessed September 29, 2009.Google Scholar
13.Steiner, H, Remsing, L, and the Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(1):126–141.CrossRefGoogle ScholarPubMed
14.CHADD: Children and Adults with Attention Deficit/Hyperactivity Disorder. Available at: www.chadd.org. Accessed September 29, 2009.Google Scholar
15.Center for the Study and Prevention of Violence. Blueprints for Violence Prevention. Available at: www.colorado.edu/cspv/blueprints. Accessed September 29, 2009.Google Scholar
16.Substance Abuse & Mental Health Services Administration's National Registry of Evidence-based Programs and Practices. Available at: nrepp.samhsa.gov. Accessed September 29, 2009.Google Scholar
17.Newcorn, JH, Spencer, TJ, Biederman, J, Milton, DR, Michelson, D. Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2005;44(3):240–248.CrossRefGoogle ScholarPubMed
18.Pliszka, S, and the AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894–921.CrossRefGoogle ScholarPubMed
19.Connor, D, Spencer, T, Kratchovill, C et al. , Effects of guanfacine extended release on secondary measures in children with attention-deficit/hyperactivity disorder and oppositional symptoms. Poster presented at: 162nd Annual Meeting of the American Psychiatric Association; May 16–21, 2009; San Francisco, California.Google Scholar
20.Scahill, L, Chappell, PB, Kim, YS et al. , A placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry. 2001;158(7):1067–1074.CrossRefGoogle ScholarPubMed
21.Turgay, A. Psychopharmacological treatment of oppositional defiant disorder. CNS Drugs. 2009;23(1):1–17.CrossRefGoogle ScholarPubMed
22.Connor, DF, Glatt, SJ, Lopez, ID, Jackson, D, Melloni, RH Jr. Psychopharmacology and aggression. I: A meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD. J Am Acad Child Adolesc Psychiatry. 2002;41(3):253–261.CrossRefGoogle Scholar
23.Reyes, M, Pandina, G, Karcher, K. Long-term safety and tolerability of risperidone in children and adolescents with disruptive behavior disorders. Paper presented at: 158th Annual Meeting of the American Psychiatric Association; May 21–26, 2005; Atlanta, Georgia. Abstract NR516.Google Scholar
24.Geller, D, Donnelly, C, Lopez, F et al. , Atomoxetine treatment for pediatric patients with attention-deficit/hyper-activity disorder with comorbid anxiety disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(9):1119–1127.CrossRefGoogle Scholar
25.Findling, RL, Biederman, J, Wilens, TE, et al, and the SLI381.301 and .302 Study Groups. Short- and long-term cardiovascular effects of mixed amphetamine salts extended release in children. J Pediatr. 2005;147(3):348–354.CrossRefGoogle Scholar
26.Daviss, WB, Bentivoglio, P, Racusin, R, Brown, KM, Bostic, JQ, Wiley, L. Bupropion sustained release in adolescents with comorbid attention-deficit/hyperactivity disorder and depression. J Am Acad Child Adolesc Psychiatry. 2001;40(3):307–314.CrossRefGoogle ScholarPubMed