NEUROPSYCHIATRY – Differential Diagnosis
Right Brain Syndrome Inability to Planning
Difficulties in Perceiving Visual Disorder
Speech development abnormalities
Dyslexia, dyscalculia Impaired motility
Minimal mental retardation ADHD
Mental retardation ?! Epilepsy
Memory Disorder Hearing Disorder
A ustic spectrum Puberty /
(Autism / -Similarly, A Sperger) adolescence
Syndrome of “stubbornness” – ODD
Toretta syndrome (Oppositional defiant disorder)
Obsessive Syndrome Conductive Disorder – CD
Depression / Bipolar Disorder / Ma
Schizophrenia / Schizoid- / schizotymic personality type / Borderline personality disorder ^
Family / Family Heredity
Environmental factors: PTSD, cultural characteristics, lack of experience
COMORBIDITY OF DIFFERENT NEUROPSYCHATRIC DISORDERS
It occurs very often. Disorders can hide and weight each other. The more associated disorders – the worse the prognosis.
^ FREQUENCY OF ACCEPTANCE OF ACCOMPANYING DEVIATIONS IN ADHD (by P. Santosh, USA)
- Syndrome of stubbornness (ODD, oppositional defiant disorder) – 40% (most likely some of these children have Asperger’s syndrome).
- Conductive conduct disorder (CD, conduct disorder) – 20% (most likely some of these children also have Asperger syn.).
- Specific problems in learning, for example, dyslexia 15-25%.
- Anxiety / anxiety syndrome 20–25% (children with Asperger syndrome are most likely also present in this group).
- Depression, bipolar disorder 15-20%.
- ASD, autism spectrum disorder 10% (In the US, Asperger syndrome is not sufficiently diagnosed).
- Tiki 15-20%.
- Speech disorders 30-35%.
ADHD AND DAMP – COMORBID, SIMULTANEOUSLY PRESENT DEFLECTIONS.
(The data was presented by Christopher Gilberg at a symposium on ADHD, Aug. 2000)
About 50% of children with ADHD also have motility disorders, then the diagnosis DAMP is used (ADHD + SNK).
About 50% of children with SNK also have attention disorders, a diagnosis of DAMP.
Common related diagnoses: anxiety, affective disorders, autism spectrum disorders, reading and writing disorders, difficulties in learning mathematics, behavioral problems, such as stubbornness syndrome (ODD), conductive disorder (CD).
B. Kadese writes that in 1999/2000, children with severe ADHD, 87% had at least one concomitant diagnosis, 67% had at least two concomitant diagnoses, and 33% had at least three concomitant diagnoses. In children with mild ADHD, the range of concomitant diagnoses is: 71% – 36% – 10%. (In the control group: 17% – 3% – 1%).
SNK in 47% of children with ADHD.
Conductive disorder and / or stubborn syndrome in 60% in the case of severe and 12% in the case of mild ADHD, most often in boys.
Ticks – in 33% (control group: 2%).
Toretta syndrome, TS, is often found with ADHD 64% (control group: 4%).
In combined Toretta + ADHD syndrome, stubborn syndrome (ODD) is also often present.
According to M. Landgren of 1996: 14% of children with ADHD also had mental retardation, compared with 2% in the group without ADHD.
^ According to L. Helgren 1994, mandepressiveness was found in 9% of children with DAMP.
23% of adolescent psychoses also had a diagnosis of DAMP.
Other common diagnoses for ADHD / DAMP (according to Gillberg 1996)
– Autistic Traits / Asperger Syndrome. With severe DAMP, about 1/5 also have Aperger syndrome A and from 1/2 to 1/4 autistic traits. It can be assumed that all people with Asperger syndrome have DAMP or ADHD in one form or another.
– Conductive disorder (CD) – in 25% of adolescents, less frequently at the end of adolescence.
– Periodic severe depression – in 50%, compared with 12% in the control group.
– Previously, more was said about diagnoses, now more is said about deviations and delays in development and about their combination.
– Previously, one diagnosis was considered sufficient, now all the necessary diagnoses are being made to describe and explain functional deviations.
– Criteria for disability: both in DSM-4 and in the legislation on the right to special assistance (LSS) special attention is paid to the problems of daily self-care and life support and the need for outside help. These points are conditions for making a diagnosis and getting help from outside.
– If a decline in functions leads to disability / need for assistance, the situation is assessed taking into account the living conditions of the person, in particular taking into account the presence of a social environment that can help.
– Currently, a multifactor model is used, positive and negative factors, strengths and weaknesses, heredity and environment factors (“well-groomed children”, receiving a lot of help, “poor in symptoms”) are being weighed.
– In causal diagnostics, genetic factors play a very important role, but there is also the idea that various factors can "call" genes (?)
– It used to be thought that many ”neuropsychiatric symptoms” are associated with emotional causes – it is currently believed that they indicate disorders of self-control functions; social behavior; perception; receiving, structuring and storing information; disorders of memory and communication skills.
However, the effects of neuropsychiatric abnormalities can be exacerbated by stress and emotional imbalance.
MENTAL DEVELOPMENT / INTELLECTUAL GIFTING DISORDERS
We are talking about those people who are not able to adapt to the environment due to the significantly reduced ability to understand that has arisen in the process of development.
Intellectual talent consists of:
– the ability to organize external impressions into an internal picture of the understanding of the surrounding reality;
– the ability to direct thoughts and actions to different goals, guided by an understanding of the surrounding reality;
– ability to develop speech, which affects the development of thinking and improves interaction with other people.
Mental deviations can be severe, moderate or moderate.
They lead to restrictions and dependencies.
DISORDERS ^ MENTAL DEVELOPMENT / INTELLIGENT DEVIATIONS
WHO (World Health Organization) with the ICD-10 diagnostic system names and shares mental disorders, based on IQ.
Mental Disorders IQ (IQ)
Coarse / deep 85
Mental retardation = IQ IQ 10% of cases of mental retardation due to the fact that the mother consumed alcohol during pregnancy)
In a child as a result of birth:
A child at an early age:
^ 3. INJURY AS A RESULT OF ASFIXIA
During childbirth – perinatal asphyxia
In early childhood:
– severe diarrhea in babies
^ 4. BRAIN INJURIES
In the process of birth – cerebral hemorrhage
– as a result of an accident
– as a result of physical abuse
^ 5. Lack of intrauterine nutrition
– being born on time, but the child is too small for his age (SGA – small for date).
DISORDERS ASSOCIATED WITH HEREALITY, AND WITH THE ENVIRONMENT
1. ^ CONGENITAL FAULTS
– deviations in the structure of the brain – disorders in structure, connections
– Wrong structure of GM vessels – Sturge-Weber
2. ^ CONGENITAL HYPOTHERIOSIS – thyroid gland insufficiency
3. DISORDERS OF AUTHISTIC SPECTRUM
(By Suzanne Danielsson)
- In 30% of patients with autism spectrum disorders, epilepsy has ever been reported;
- Concomitant mental retardation is ascertained in 50% of patients;
- In severe epilepsy, about 30% also have autism spectrum disorders;
- 0.5% of all schoolchildren have epilepsy, every fifth of them is ADHD;
- 80% of children with epilepsy recover when they become adults;
- Related issues complicate things.
Mental retardation occurs in approximately 20% of adults with a diagnosis of epilepsy and in 30% of children with a diagnosis of epilepsy.
Mental retardation = IQ