Saturday, March 12, 2015
Managing the Difficult Child
Anthony L. Rostain, MD, MA, University of Pennsylvania
Dr. Rostain reviewed diagnostic criteria for oppositional defiant disorder (ODD), conduct disorder (CD), and disruptive mood dysregulation disorder, which is new in DSM-5. Disruptive behavior disorders often are comorbid with other psychiatric disorders, and there is symptomatic overlap between attention-deficit/hyperactivity disorder (ADHD) and ODD. Assessment of aggressive behaviors begins with a thorough history that includes a description of the aggression; responses by parents, caregivers, teachers, and school staff; and quantifying the aggression using a rating scale. Pharmacotherapy of aggression includes atypical and typical antipsychotics, stimulants, anticonvulsants, lithium, alpha-2 agonists, and beta blockers. Treatment should be individualized and guided by underlying psychiatric illness.
