Hyperactivity disorder without treatment, scholar failure and future non-integrated children? The role of the Primary Care doctor: in relation to one case

Attention deficit/hyperactivity disorder (ADHD) is the most common psychiatric disease in childhood and the first cause of scholar failure. It is the cause or coexist with other severe conditions like oppositional-deafiant disorder (ODD) and conduct disorder (CD). The last one appears in adolescents and in children younger than 10 years and provokes lack of school integration, rupture of social norms and even commission of criminal acts. Case report: a 10 year-old boy with scholar failure, home and school disturbances in behaviour that included physic violence directed to mates and teachers. A preliminary diagnosis of disruptive behaviour disorder was made and the patient was referred for specialized psychiatric evaluation. The final diagnosis was dissocial behavior disorder in an unsocialized child. Metylphenidate treatment resulted in an evident improvement of behaviour and academic performance. When faced with a possible ADHD case, the Primary Care pediatrician?s role should be early detection, starting of treatment when indicated and assessment of therapeutic results. Early diagnosis is of paramount importance in this disorder because it can drives to a normal development of the patient avoiding an eventual evolution to a more severe condition.