1. A CASE OF OPPOSITIONAL DEFIANT DISORDER By Dr. Jawahar Shah M.D.(Hom)

2. NOTE: To protect the patient’s identity, we have used a model’s picture or photographs for the purpose of presentation.

3. Case of Attention Deficit and Disruptive Manipulative Behavioral Disorder + Oppositional Defiant Disorder Case of Attention Deficit and Disruptive Manipulative Behavioral Disorder + Oppositional Defiant Disorder

4. A female child, 5 years old, was brought in 1982 with peculiar complaints. A female child, 5 years old, was brought in 1982 with peculiar complaints. The child would pass urine and stool daily as soon as she would reach the staircase of her house. The child would pass urine and stool daily as soon as she would reach the staircase of her house.

5. To avoid this, the mother would daily pick up the child from the school, would make her pass urine and /or stool in school; but still, this did not solve the problems. To avoid this, the mother would daily pick up the child from the school, would make her pass urine and /or stool in school; but still, this did not solve the problems.

6. In spite of this, the child would still pass stool and urine on the staircase, In spite of this, the child would still pass stool and urine on the staircase, even when there were no apparent reasons in doing so.

7. On detailed interview of the child separately, we came out with some interesting facts... On detailed interview of the child separately, we came out with some interesting facts... The child was extraordinarily intelligent, smart, witty, and had a lot of presence of mind.

8. When slowly probed into the depth of the case, The child revealed that the mother gave more attention to younger brother who was 3 years younger to her. When slowly probed into the depth of the case, The child revealed that the mother gave more attention to younger brother who was 3 years younger to her.

9. Secondly, their mother would lock them and leave them all alone in the house. Secondly, their mother would lock them and leave them all alone in the house.

10. Thirdly, the child always felt that her mother did not give things desired by her, and would often hit or punish her. Thirdly, the child always felt that her mother did not give things desired by her, and would often hit or punish her.

11. The child acted in this manner on purpose. She would do this act of passing stool and urine to take revenge. The child acted in this manner on purpose. She would do this act of passing stool and urine to take revenge.

12. The child said ‘it was my way of taking revenge on my mother, who is not treating me in the right way’. The child said ‘it was my way of taking revenge on my mother, who is not treating me in the right way’.

13. Basically, the child was : Very mischievous and disobedient. Would never take any orders given by teacher or anybody. Basically, the child was : Very mischievous and disobedient. Would never take any orders given by teacher or anybody.

14. Very destructive in nature. Would tear off books or break toys. Attitude was very revengeful. Would often hit other children. Very destructive in nature. Would tear off books or break toys. Attitude was very revengeful. Would often hit other children.

15. A Case of Attention Deficit and Disruptive Behavioural Disorder. It satisfies the diagnostic criteria 313.81 of the Oppositional Defiant Disorder. A pattern of Negativistic Hostile and Defiant Behaviour lasting for 6 months or more A Case of Attention Deficit and Disruptive Behavioural Disorder. It satisfies the diagnostic criteria 313.81 of the Oppositional Defiant Disorder. A pattern of Negativistic Hostile and Defiant Behaviour lasting for 6 months or more

16. Child often loses temper. Often argues with adults. Often actively defies and refuses to comply with adults’ requests or rules. Often deliberately annoys people. Child often loses temper. Often argues with adults. Often actively defies and refuses to comply with adults’ requests or rules. Often deliberately annoys people.

17. Often blames her mother for her misbehaviour. Is often angry and resentful. Is often spiteful or vindictive. Often blames her mother for her misbehaviour. Is often angry and resentful. Is often spiteful or vindictive. This disturbance has caused significant impairment in social and academic functioning.

18. Symptoms considered : Deceitful, Sly Mischievous Malicious, spiteful, vindictive Destructiveness Symptoms considered : Deceitful, Sly Mischievous Malicious, spiteful, vindictive Destructiveness

19. Symptoms considered : Disobedience Witty Mood, disposition: Impudent, insulting, malicious Tears : Things : Books, his Symptoms considered : Disobedience Witty Mood, disposition: Impudent, insulting, malicious Tears : Things : Books, his

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21. Repertorisation :

22. This picture is typical of Tarentula hispanica, a child who is intelligent and witty yet very sly, crafty, revengeful and malicious in her acts. This picture is typical of Tarentula hispanica, a child who is intelligent and witty yet very sly, crafty, revengeful and malicious in her acts.

23. Tarentula patients enjoy giving pain and discomfort to others and derive a lot of pleasure out of it. Tarentula patients enjoy giving pain and discomfort to others and derive a lot of pleasure out of it.

24. References from Archives : Phatak in his Text book of Materia Medica says...‘Tarentula patients are : Crafty Cunning Selfish Destructive destroys whatever she can lay hand on....etc.’ References from Archives : Phatak in his Text book of Materia Medica says...‘Tarentula patients are : Crafty Cunning Selfish Destructive destroys whatever she can lay hand on....etc.’

25. Prescription : 24 th September, 1982 Remedy : Tarentula H. 200, 3 doses, 1 every night. S.L 1-1-1 * 4 weeks. Prescription : 24 th September, 1982 Remedy : Tarentula H. 200, 3 doses, 1 every night. S.L 1-1-1 * 4 weeks.

26. Follow up : 9 th November, 1982 Within 2 weeks, the child stopped passing stool and urine on the staircase. Behavior >> No complaints now. Remedy : S.L 3 doses 3 Per Night S.L 1-1-1 * 3 weeks. Follow up : 9 th November, 1982 Within 2 weeks, the child stopped passing stool and urine on the staircase. Behavior >> No complaints now. Remedy : S.L 3 doses 3 Per Night S.L 1-1-1 * 3 weeks.

27. 13 th December, 1982 Irritability +++ Jealously towards brother Negative relationship with brother Marked restlessness Remedy : Tarentula H. 200 3 doses 1 every night. S.L 1-1-1 * 4 weeks. 13 th December, 1982 Irritability +++ Jealously towards brother Negative relationship with brother Marked restlessness Remedy : Tarentula H. 200 3 doses 1 every night. S.L 1-1-1 * 4 weeks.

28. The remedy helped in channelising the child’s intelligence into good use. The remedy helped in channelising the child’s intelligence into good use.

29. The child improved remarkably in her scholastic performance and received the best student award during later years. The child improved remarkably in her scholastic performance and received the best student award during later years.

30. Clinic No. 2, Cupid Apt., 66-E, Linking Road, Khar(West), Mumbai – 400052, Maharashtra, India. T: +91 22 2604 0527/ 5713 (5:00 PM – 8:30 PM) T: +91 22 61417800 – 99 (100 Lines) E: info@specialtyclinic.com www.speacialtyclinic.com To know more about Dr. Jawahar Shah, click here www.specialityclinic.com/DrJawaharShah