Attention-Deficit Disorders and Disruptive Behaviour MCQs

Explanation: Untreated Attention-Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with an increased risk of developing Conduct Disorder during adolescence. Children with ADHD often display impulsivity, aggression, and difficulty following rules, which may escalate into more severe behavioural problems, including violating the rights of others and engaging in antisocial behaviour . Explanation for other options: Binge eating (Option A) is not typically associated with untreated ADHD, although some individuals with ADHD may engage in emotional eating. Selective mutism (Option B) is more commonly associated with anxiety disorders and is not directly linked to ADHD. Separation from parent leading to depression (Option C) is not a common progression from ADHD, though emotional difficulties can arise, especially in children with comorbid conditions

Cocaine(or other stimulants such as amphetamine) intoxication can present with Euphoria Irritability Anxiety Psychotic symptoms such as paranoia Elevated vital signs Conversely, intoxication with alcohol, barbiturates, benzodiazepines and opiates generally causes depression, somnolence and depressed vital signs(OPTIONS A, B, & C). Reference: Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 20.9, Stimulant-related disorders, Page no. 675.

In delirious state, the patient becomes more disturbed, disoriented, hyper vigilant towards the evening after sunset due to sensory deprivation. This is known as sun downing. Reference: Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 10 th edition, Chapter 10.2 Delirium, Page number 3062.

Patients with obsessions usually harbour their difficulties for a long time (often 5 to10 years) before they present to a doctor . (Option A & B) The ego-dystonic nature of obsessions results in anxiety and reduces help seeking and sharing of their secret illness. OCD has its origin in adolescence or childhood . But most patients do not seek help until they are in their twenties or thirties . Often the onset of depression brings OCD to clinical attention. Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 10, page no. 423

Intermittent Explosive disorder, Kleptomania and Pyromania are classified as Disruptive and Impulse Control disorders seen in adulthood. Whereas Oppositional defiant disorder and Conduct disorder are seen in childhoodor adolescence . Reference: Kaplan and Sadock’s Synopsis of Psychiatry, 11 th edition, Chapter 19 Disruptive, Impulse control, and Conduct disorders, Page number 608.

Explanation: The DSM-5 emphasizes the child's self-perception and the desire or insistence that one is another gender as the most critical criterion for gender dysphoria in children. Other behaviours (like preference for opposite-gender clothing or playmates) are supportive but not primary diagnostic criteria. Gender Dysphoria In Children: Key Diagnostic Criterion: The most critical factor for diagnosing gender dysphoria in children is desire or insistence on being another gender. Behavioural Characteristics: Preference for clothing, toys, and games typically associated with the opposite gender. Desire to take on roles of the opposite gender during play. Rejection of same-gender stereotypes and preference for other-gender playmates. Dislike of their own sexual anatomy or a desire to have the sexual characteristics of the desired gender.

DSM-5 has divided oppositional defiant disorder into three types: Angry/Irritable Mood Argumentative/ Defiant Behaviour Vindictiveness Crying is not a sub-type of Oppositional Defiant Disorder. Reference : Kaplan and Sadock’s Synopsis of Psychiatry, 11 th edition, Chapter 31.12 Oppositional Defiant Disorder, Page number 1244.

Individuals with conduct disorder can exhibit a persistent interpersonal and emotional pattern that can be characterized by at least two of the following: Lack of remorse or guilt Callous lack of empathy Unconcerned about performance Shallow or deficient affect. Communication skills, however, are not lacking in those with conduct disorder. Reference : Kaplan and Sadock’s Synopsis of Psychiatry, 11 th edition, Chapter 31.12 Conduct disorder, Page number 1247.