Treating ADHD and Comorbid Disorders: Psychosocial and Psychopharmacological Interventions

Treating ADHD and Comorbid Disorders: Psychosocial and Psychopharmacological Interventions

by Steven R. Pliszka
     
 

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Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently experience co-occurring problems with aggression, mood swings, tics, anxiety, or depression. Organized around detailed case presentations, this highly informative book helps the clinician make sound decisions when assessing and treating the full range of ADHD comorbidities.

Overview

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently experience co-occurring problems with aggression, mood swings, tics, anxiety, or depression. Organized around detailed case presentations, this highly informative book helps the clinician make sound decisions when assessing and treating the full range of ADHD comorbidities. Experienced child psychiatrist Steven Pliszka offers straightforward guidance on how to avoid common diagnostic errors, develop an individualized medication regimen, minimize health risks and side effects, collaborate successfully with parents, and tailor psychosocial treatments to each family's needs. A reproducible structured interview facilitates sorting out symptoms and distinguishing between different comorbid disorders.

Editorial Reviews

Doody's Review Service
Reviewer: Richelle Strauss, MD (Rush University Medical Center)
Description: This is a review of available evidence, augmented by the author's own clinical research, about the most common comorbid conditions of ADHD: ODD and conduct disorder, impulsive aggression, bipolar disorder, depressive disorders, anxiety disorders, OCD, and intellectual disability and autism spectrum disorders. It summarizes clinically relevant literature (e.g. full discussions of the MTA and CMAP studies including CMAP algorithm) and includes helpful descriptions of commonly used statistics terms and calculations. Appendix I is structured clinical interviews and Appendix II is a summary of pertinent psychopharmacology. This is a clinical case-based version of an earlier book, ADHD with Comorbid Disorders: Clinical Assessment and Management by this author with two others (Guilford, 2001).
Purpose: The author sought to provide an evidence-based clinical guide that combined medical evidence with clinical judgment. He addresses many common clinical challenges, such as characterizing mood dysregulation and many psychiatric symptoms shared by several DSM diagnoses (e.g. aggression/explosive behavior). He intended to provide a toolkit for practicing clinicians dealing with difficult clinical cases and he has accomplished this goal with this readable and clinically applicable book.
Audience: The author appears to target clinicians dealing with the difficult presentations in children with ADHD and comorbid conditions. However, the book appears to be most appropriate for fellow-level trainees. It would likely be a review for individuals already established in clinical practice. The author draws from his two decades of experience in traditional outpatient and residential settings which obviously supplies the clinical judgment he lends to the book.
Features: The book is organized into chapters named for the various comorbidities with ADHD. Discussions of evidence and clinical problems are interrupted at a comfortable pace by case examples, algorithms, diagrams, and educational points on how to calculate odds ratios, powers, and other relevant statistics. Among the book's strengths are the way it presents an easily consumable amount of the most clinically relevant evidence, provides education on how to evaluate the evidence, and illustrates the concepts with refreshingly complex clinical cases. Some could criticize its restraint in not listing every piece of evidence on each topic, but this would have made it far more difficult to read.
Assessment: This book really does serve as a complete toolkit to help readers attend to the most clinically relevant evidence on the subject, analyze the evidence, and apply it to clinical situations as complex as any I have encountered in practice. I was grateful to be able to take away not only an education on basic and controversial clinical topics in ADHD and comorbid disorders with a complete discussion of relevant psychopharmacology, but also a review of how to analyze a piece of literature and how to structure a complete initial evaluation interview. I would strongly recommend it to any fellow-level trainee or new clinician in child and adolescent psychiatry.
Metapsychology Online Reviews
"A psychiatrist who splits his time between research and clinical practice, Pliszka is in an ideal position to translate recent studies on ADHD treatment into useful guidelines for clinicians, and his book does not disappoint. The book is clearly written, well-organized, and a thoughtful integration of clinical wisdom and cutting-edge research....Multiple narrative case studies are also included in each chapter, to illustrate the concepts covered....A helpful guide for practitioners who are looking for an accessible overview of research on ADHD comorbidity as well as down-to-earth advice about how to treat children who present with a variety of problems that include ADHD-related symptoms."
Special Education Needs Magazine
"The individual case studies are lively and informative, bringing the dilemmas facing the clinician into sharp focus for the reader....Will be of interest to child psychiatrists, psychologists, and practitioners interested in learning more about the complexities of clinical work with children with ADHD."
European Child and Adolescent Psychiatry
"This is a remarkable book. It starts where many monographies on developmental disorders stop. It addresses challenges of treatment and guidance in a complex developmental disorder such as ADHD. Moreover, it addresses the issue of comorbidity, which is present in the great majority of ADHD cases; and if not yet present will develop subsequently. The book has the double advantage of being both a comprehensive textbook and a desktop guide....This is an ideal book for practitioners and a must for residents."
From the Publisher
"Over 80% of children and adults with ADHD manifest at least one coexisting psychiatric, developmental, or learning disorder, which may alter the clinical presentation of ADHD and affect treatment response. This book is therefore an exceptionally welcome addition to the literature. Pliszka is an internationally recognized expert on the clinical management of ADHD. Staying close to the science of the disorder, on which thousands of research studies have been published, he guides the reader through the thicket of potential comorbid disorders, their differential diagnosis, their impact on adaptive functioning, and their implications for tailoring a package of treatments for each individual case."—Russell A. Barkley, PhD, ABPP, Department of Psychiatry, Medical University of South Carolina
 
"This book offers a rich clinical source of useful information about what is currently known about children and adolescents suffering from comorbid ADHD. Pliszka's gripping prose and clinical wisdom are impressive and delightful, especially for those of us dealing with vexing therapeutic challenges."—Laurence L. Greenhill, MD, Ruane Professor of Clinical Psychiatry, New York State Psychiatric Institute, New York, New York
 
"This book is a true gem. Synthesizing diagnostic, etiological, and treatment research on ADHD and comorbid disorders, Pliszka provides a concise yet sophisticated summary of up-to-date findings. I especially appreciate the clinical case material in every chapter. The cases resonate with the challenges and dilemmas that clinicians face and show how a master clinician carefully brings to bear an evidence-based approach to state-of-the-art patient care. The book also addresses a number of controversies related to ADHD and helps us find perspective. Pliszka’s balanced blend of the best psychosocial and medication treatment approaches will make this book of keen interest to a broad audience, including child psychiatrists, pediatricians, psychologists, social workers, and students of child behavior and intervention."—James T. McCracken, MD, Professor and Director, Division of Child and Adolescent Psychiatry, UCLA Semel Institute
 
"Clinically focused, case centered, and comprehensive in scope. Drawing on his years of experience as a child and adolescent psychiatrist and researcher, Pliszka has written a book that is firmly grounded in the scientific literature and presents much practical information for the clinician. The many case vignettes illustrating the complexities of clinical work with youngsters with ADHD are especially useful. For ADHD researchers, the book provides an indispensable, up-to-date review of the field. Students in psychology, social work, and psychiatry will find much of value in this lucidly written book."—Daniel F. Connor, MD, Lockean Distinguished Professor of Psychiatry; Chief, Division of Child and Adolescent Psychiatry, University of Connecticut School of Medicine

Product Details

ISBN-13:
9781606233993
Publisher:
Guilford Publications, Inc.
Publication date:
05/20/2009
Sold by:
Barnes & Noble
Format:
NOOK Book
Pages:
242
File size:
4 MB

Meet the Author

Steven R. Pliszka, MD, is Dielmann Distinguished Professor and Chair of the Department of Psychiatry of the University of Texas Health Science Center at San Antonio, where he served as Chief of the Division of Child and Adolescent Psychiatry from 1995-2015. Throughout his career, Dr. Pliszka has been involved in a wide range of administrative, research, clinical, and educational activities. His research focuses on attention deficit/hyperactivity disorder (ADHD) and related disorders; he has been involved with numerous clinical trials of medications for ADHD and currently uses functional magnetic imaging to try to understand the mechanisms of action of ADHD treatments. He has also been involved in several projects to integrate mental health services into pediatric primary care. Dr. Pliszka maintains an active clinical practice and serves as the attending psychiatrist for two residential facilities for children with severe behavioral and emotional disorders. 


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