Children and adolescents who do not receive proper treatment for attention deficit hyperactivity disorder (ADHD) have increased risk of developing disruptive mood dysregulation disorder (DMDD), the Taiwanese Society for the Study of Attention said yesterday.
The group cited a case in which a 17-year-old high-school student used to lose his temper at least three times a week.
He would often break and throw things, swear, act violently toward his family members and even get irritated when they asked him to take a bath, leading his family to persuade him to seek medical attention.
Stress from schoolwork, and mocking and isolation from his classmates made him hate going to school and more susceptible to becoming irritated and anxious, it said, adding that he would play online games for long hours to avoid others and would lose his temper if he was not allowed to play.
After consulting with doctors, the student was diagnosed with ADHD, society chairperson and Mackay Memorial Hospital Department of Pediatric Psychiatry doctor Tzang Ruu-fen (臧汝芬) said.
About 5 to 7 percent of children and teenagers have ADHD, but less than 2 percent seek medical treatment, mainly because people lack proper knowledge and stigmatize the condition, Tzang said.
Such cases are not uncommon, but ADHD can only be diagnosed by trained specialists, she said, adding that early detection and intervention, in addition to medication or cognitive behavioral therapy, show the best results.
Many parents might think it is natural for children to throw tantrums, but they should observe whether their child is only experiencing temporary anxiety, or whether they are easily irritated, start blaming others and find it difficult to calm down, Tzang said.
If parents observe behavior they find concerning, they should consult with pediatric psychiatrists, she added.
DMDD has two main symptoms: severe, recurrent tempers that are out of proportion in intensity or duration, and a persistently irritable mood that is observable by others, Taipei Veterans General Hospital Department of Psychiatry physician Chen Mu-hong (陳牧宏) said.
Some children with DMDD were treated for bipolar disorder before the condition was identified, he said, adding that a significantly high rate of children with DMDD also have ADHD, and treatment methods require further study.
“We often see an angry child, but we do not know why they are angry, and the child cannot clearly express the reason for their anger,” Chen said, adding that the child must not only be observed, but their home, school and life environments must also be evaluated.
“There is no problematic child, only a child in trouble,” he said, adding that better treatment comes from proper diagnosis.
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