What is true about oppositional symptoms in patients with ADHD

A. They can be part of the diagnostic criteria for ADHD in children B. They can be confused with impulsive symptoms of ADHD C. They can be part of oppositional defi ant disorder (ODD) which can be

comorbid with ADHD D. They can be part of conduct disorder (CD) which can be comorbid

with ADHD

Patient Intake • 8-year-old girl brought to her pediatrician by her 26-year-old mother • Chief complaint: fever and sore throat

Psychiatric History • While evaluating the patient for an upper respiratory infection, the

pediatrician asks if school is going well • The patient responds “yes” but in the background the mother shakes

her head “no” • The mother states that her daughter is negative and defi ant at home

and she has similar reports, mostly of disobedience, from her teacher at school

• The patient has had temper tantrums since age 5 but these have decreased over the past 3 years, especially the past year

• Still angry and resentful since her little sister was born 6 years ago • Academic problems • Fights with other children, mostly arguments and harsh words with

other girls at school

Social and Personal History • Goes to public school • Has a younger sister age 6 • Does not see her father much, lives in a nearby city • Not many friends • Spends most of her time with her sister and either her mother or her

maternal grandmother who helps with after school supervision and baby sitting

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