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Chapter 44: Child & Adolescent Psychiatry

Which of the following is the most effective treatment for attention-deficit/hyperactivity disorder (ADHD)?

A. Fluoxetine

B. Clonidine

C. Valproate

D. Methylphenidate

E. Atomoxetine

D. The most effective treatment for ADHD is a stimulant such as methylphenidate or amphetamine. Fluoxetine is a selective serotonin reuptake inhibitor and is used for a variety of depressive and anxiety disorders. Clonidine is an α agonist that can be used to treat ADHD, but it is not the first-line treatment. Valproate is an antiepileptic drug that can be used to treat seizures or bipolar disorder in adolescents. Atomoxetine is a selective norepinephrine reuptake inhibitor that can also be used in ADHD but is not as effective as stimulants in most patients.

Which of the following is a true statement about tic disorder?

A. The onset of tic disorder is rarely before the age of 12 years.

B. Prevalence of tic disorder is higher in females.

C. Tourette syndrome is diagnosed when both multiple motor tics and 1 or more vocal tics have been present at some time during the illness, although not necessarily concurrently.

D. Tic disorder continues to worsen throughout adolescence, and most people live with severe symptoms throughout adulthood.

E. Medication should be started as soon as the first symptom occurs.

C. The onset of tic disorder is typically between age 4 and 6 years, and peak onset occurs between ages 10 and 12 years. Prevalence of tic disorder is higher in males. Symptoms of tic disorder wax and wane in severity and change in affected muscle groups and vocalizations over time. Many adults with tic disorders experience diminished symptoms in adulthood. Medication is recommended when tics result in significant subjective discomfort, pain, or ongoing social problems.

Which of following symptoms of major depressive disorder (MDD) is more prominent in child and adolescents compared to adults?

A. Insomnia

B. Irritable mood

C. Loss of energy

D. Loss of interest

E. Feeling worthless

B. In children and adolescent, depression often presents as irritability rather than depressed mood.

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