Psychiatry - August 2008 - (Page 43)

[PSYCHOTHERAPY ROUNDS] SERIES EDITOR: PAULETTE M. GILLIG, MD, PhD Professor of Psychiatry, Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio. Managing Attention Deficit Hyperactivity Disorder in the Emergency Department by KATHERINE T. KLYKYLO, MHSA, ACSW, and WILLIAM M. KLYKYLO, MD Ms. Klykylo is with the Psychiatric Emergency Services, a joint program of the University of Michigan Department of Psychiatry and the Washtenaw County Health Organization (WCHO) in Ann Arbor, Michigan; and Dr. Klykylo is the Professor and Director, Division of Child and Adolescent Psychiatry, Wright State University School of Medicine in Dayton, Ohio. Psychiatry (Edgemont) 2008;5(8):43–47 ABSTRACT ADHD, often misdiagnosed or unrecognized, can lead to serious personal and family disruption. Younger patients with ADHD frequently present to hospital emergency departments with crises involving behavioral dyscontrol, legal, school or family conflict, and substance abuse. An emergency room visit provides an excellent opportunity to use such crises as catalysts to effect lasting change in these patients and their families. The efficacy of a biopsychosocial model is demonstrated in a case involving a 15-year-old boy presenting to the emergency department with legal, psychological, educational, and family problems. Multiple teaching points are highlighted throughout the case. INTRODUCTION This case epitomizes the need for early and multimodal intervention in the treatment of attention deficit hyperactivity disorder (ADHD).1,2 Despite the increased public awareness of this disorder and the plethora of pharmacologic agents for its treatment, it remains a major cause of personal misfortune and social cost.3,4 The treatment of ADHD 43 EDITOR’S NOTE: All cases presented in the series “Psychotherapy Rounds” are composites constructed to illustrate teaching and learning points, and are not meant to represent actual persons in treatment. ADDRESS CORRESPONDENCE TO: Katherine Klykylo, MHSA, ACSW, University of Michigan Psychiatric Emergency Services / WCHO, 1500 East Medical Center Drive, Floor B1, Room B1C204, Ann Arbor, MI 48109-5020; Phone: (734) 996-4747; E-mail: klykylo@umich.edu KEY WORDS: ADHD, substance abuse, adolescent psychiatry, emergency psychiatry, educational problems, legal problems, families, biopsychosocial approach [AUGUST] Psychiatry 2008 43

Table of Contents Feed for the Digital Edition of Psychiatry - August 2008

Psychiatry - August 2008 Editor’s Message Editorial Advisory Board Contents Borderline Personality Disorder: Are Proliferative Symptoms Characteristic? Short-acting versus Long-acting Medications for the Treatment of ADHD Baby Stimuli and the Parent Brain: Functional Neuroimaging of the Neural Substrates of Parent-Infant Attachment These Boots Are Made for Stalking: Characteristics of Female Stalkers Managing Attention Deficit Hyperactivity Disorder in the Emergency Department Obstructive Sleep Apnea, Hypoxia, and Metabolic Syndrome in Psychiatric and Nonpsychiatric Settings Improving the Quality of Life in Patients with Alzheimer’s Disease The Process of Getting New Drugs to Market Journal Watch Classified Advertising Information for Authors

Psychiatry - August 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.