PS2.209ADHD or just plain rudeness: what’s the GP’s role? About a clinical case

Author(s): 
Vera Pires da Silva
USF Ramada, ACES Loures - Odivelas, Lisbon, Portugal
Corresponding author: Dr Vera Pires da Silva, USF Ramada, ACES Loures -Odivelas, Lisbon, Portugal.
E-mail: vera.psilva@gmail.com
Text: 
Background & Aim: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. It has two categories of core symptoms: hyperactivity/impulsivity and inattention and this behaviour results in evidently impaired functioning in multiple settings as symptoms affect cognitive, academic, behavioural, emotional, and social functioning. The complaint regarding symptoms of ADHD may originate from the parents, teachers, or other caregivers.
Methods:  Data was gathered from interviews with the child and her mother, analysis of patient’s clinical records including medical history, physical examination, diagnostic procedures, treatment and evolution. A literature review about the subject was also performed.
Results: 10-year-old boy, normal birth and development history. Mother refers being exhausted with his rudeness and claims his older sister has had the same education and doesn’t have that behaviour. Refers difficulty waiting turns, remaining seated when sitting is required, maintaining attention in play, school, or home activities, interruption or intrusion of others and seems not to listen, even when directly addressed. He was referred to a specialist and had the diagnosis of ADHD, started psychotherapy and medication with good outcomes.
Conclusion: Most children get distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may be mistaken for ADHD. On the other hand, adults may think that children with the hyperactive and inattention subtypes just have emotional or disciplinary problems. Diagnosis and therapy for ADHD is complex and should be done by experts in this field. However, there’s room for GPs. Children can be offered professional support within the primary care setting, provided sufficient knowledge and expertise is available and there is collaboration with other health care providers. The main task of the GP is making the right choice concerning when to refer for further diagnosis and treatment.