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Psychiatry · USMLE Step 1

USMLE Psychiatry: Child and Adolescent Disorders

ADHD, autism spectrum disorder, conduct disorder, and other child and adolescent psychiatric conditions tested on USMLE Step 1.

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What is the minimum duration of symptoms required to diagnose ADHD?
At least 6 months
By what age must several ADHD symptoms be present for diagnosis?
Before age 12
In how many settings must ADHD symptoms be present for diagnosis?
At least 2 settings (e.g., home and school)
What is the first-line pharmacologic treatment class for ADHD?
Stimulants (methylphenidate or amphetamines)
What is the mechanism of action of stimulant medications used for ADHD?
They increase synaptic dopamine and norepinephrine by blocking reuptake and promoting release
What is the mechanism of atomoxetine, a non-stimulant ADHD medication?
Selective norepinephrine reuptake inhibitor
What is one of the two core diagnostic domains of autism spectrum disorder?
Persistent deficits in social communication and social interaction
What is the second core diagnostic domain of autism spectrum disorder?
Restricted, repetitive patterns of behavior, interests, or activities
Autism spectrum disorder is more common in which sex?
Males (about 4 times more common than females)
Which disorder presents with normal early development in a girl followed by regression, loss of purposeful hand use, and repetitive hand-wringing?
Rett syndrome
What gene mutation causes Rett syndrome?
MECP2 gene mutation (X-linked)
Which disorder is characterized by normal development until age 2 followed by significant loss of previously acquired language, social, and motor skills?
Childhood disintegrative disorder (Heller syndrome)
What is the core definition of conduct disorder?
A repetitive pattern of behavior violating the rights of others or societal norms, such as aggression, destruction of property, deceitfulness, or serious rule violations
What is the age cutoff distinguishing childhood-onset from adolescent-onset conduct disorder?
Age 10 (onset before age 10 is childhood-onset type)
Untreated conduct disorder is a risk factor for progression to which adult diagnosis?
Antisocial personality disorder

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