ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults diagnosing ADHD requires a thorough evaluation by a specialist who is trained in the disorder. They'll likely inquire about your history and perform a physical exam. They'll also rule out other conditions that could be a cause of ADHD like mood disorders, learning disorders, or thyroid problems.
The doctor will also ask about your childhood behaviors as the current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of signs from childhood. This could include obtaining school records and contacting former teachers, religious leaders or coaches.
Signs and symptoms
You could be suffering from ADHD in the event that you or someone you know is struggling to keep up at school, work, or at home. If they're unable to remember important dates or appointments or aren't able to keep track of important dates or appointments, then you might be suffering from ADHD. Getting an evaluation by an expert in health care can help you determine whether this is the case, and If it is an issue, what treatment options are available.
The symptoms must be present in at least two different environments (school and at home, for example) and for at least six months to be able to qualify for an ADHD diagnosis. The symptoms must also be hindering your ability to function for instance in class, creating close relationships, or working in a group. It is important to recognize that everyone has difficulty staying organized and paying attention at times, but these issues are more severe in the case of ADHD.
In order to make a diagnosis, your provider will interview you and ask you questions about your behavior and how it's affected your life. The doctor will also look at your family history, as well as any previous medical or psychological tests you've taken. They will check for health problems, such as thyroid disorders and seizures, which can cause similar symptoms as ADHD.
Your doctor will want to know if your symptoms started in childhood (technically at the age of 12). Your doctor will also be interested in knowing what your symptoms are doing to you at the moment and in the past. They'll want to know if you've been diagnosed with ADHD in the past.
It's helpful to bring your own list of symptoms to your appointment, particularly if you have them written down. This will help you remember them and give your physician a an accurate picture of how your symptoms affect you. You can also bring documents, such as the performance evaluations you receive from work or old school report cards. These documents can help your doctor determine if ADHD is a new issue or has been present for a long time. These records can help your provider to rule out other conditions like depression and anxiety that have similar symptoms as ADHD.
History
In the past, ADHD was thought to be a flaw in character or laziness. With advances in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma associated with this disorder is fading.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He described his observations of children who were inattentive and unable to focus. He also noted that these symptoms were more prevalent in boys than in girls and were not related to the home environment or intelligence. Still's report is often credited as the beginning of official recognition of ADHD.
The initial version of the psychiatric handbook, published in 1952 by the American Psychological Association (APA) did not include ADHD. In 1955, however, the US FDA approved stimulant drugs which were used as the primary treatment for ADHD. In 1968 the APA released its second edition that included a variety of mental health disorders. It also included symptoms of ADHD even though they were still referred to as hyperkinetic reaction of childhood.
In 1994 the fourth edition of psychiatric book was released. This led to greater understanding and acceptance of ADHD. Its name was changed to Attention Deficit Disorder with or without hyperactivity and the standard definition of three types of ADHD symptoms was established: mostly inattentive, mainly hyperactive-impulsive, and combined. The current DSM-5 defines these as presentations, rather than distinct types, and says that they may change over the course of a person's life.
NICE (National Institute for Clinical Excellence) has released guidelines on ADHD in adults in 2008. This was the first time that the UK as a whole recognized adults with ADHD and provided them with funding, healthcare support and guidance. SIGN (Scottish Intercollegiate Guidelines Network), has also released guidelines on ADHD in children. These two documents are the sole official NHS Scotland guidelines on the condition. Private and non-profit organizations have also produced guidance. In recent times there has been a growing interest in the biological causes of ADHD, and researchers have begun to find the genes responsible for it. This information can help develop better targeted, more effective treatments in the near future.
Physical Exam
A specialist in ADHD will conduct a thorough examination to diagnose the condition. It doesn't matter if they are a physician who specializes in mental health (such as a psychologist or psychiatrist) or a doctor trained in child and young health (a paediatrician), they will want to gather a variety of details about the person's past that includes family, educational, work and social histories. They will look over the school records from the past and interview teachers, coaches and other professionals who know the person. They will ask questions about the symptoms, and how they affect daily life. They will also examine how symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, lays out the criteria for diagnosing ADHD in both adults and children. To meet these criteria, the symptoms of inattention and hyperactivity-impulsivity must be present in multiple settings, cause significant impairment and have started before age 12. A specific questionnaire adapted to the particular situation will be administered by the doctor to ask the patient about their symptoms. adhd undiagnosed in adults may also employ a variety of rating scales that look at different aspects of the ADHD symptoms. Some of these ratings will be built on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults while others will be based on other factors, including questions such as "Do you have difficulty sitting still?" and "Do you have difficulty to manage your time or tasks?"
They will conduct a physical examination. They will determine if there are any medical conditions that could be creating the symptoms or causing them to become worse, such a thyroid problem, vision or hearing issues. They will also inquire with the patient about their diet and lifestyle habits in order to determine if these may contribute to symptoms.
Someone who is being assessed for ADHD as an adult is likely to be asked to complete a questionnaire with their partner or close friend. This provides a deeper understanding of the individual that checklists and questionnaires can't provide. This can be particularly useful for people with comorbid conditions like anxiety or depression that often co-occur with ADHD and make the symptoms harder to identify.
Psychological Evaluation
If a health care professional evaluating a child or adult for ADHD first interviews them, they ask a series of questions regarding how their symptoms affect their daily lives. They also examine the history of the patient's family and their mental health.
They could request copies of the student's report card or school records, specifically those from kindergarten through high school. They may also ask for copies of any previous psychological or neuropsychological testing, such as results from IQ tests and assessments for learning disabilities.
A psychiatrist, psychologist or social worker usually will conduct the interview portion of an adhd diagnostic assessment. They may also interview friends, family members and teachers as well as employers. It is essential to have a comprehensive evaluation because people who suffer from untreated ADHD may have serious issues such as financial issues (impulsive spending) or marital issues, as well as failing in college or other educational institutions.
During the interview, the doctor will usually ask the patient to complete standardized behavior rating scales that are designed to identify ADHD symptoms. These tests are based on research that compares the behaviors of individuals with ADHD to those of people without the disorder. These scores are not a diagnosis of ADHD however they play an important part in the process of evaluating.
It is also important to evaluate the individual for other ailments that may have similar symptoms to ADHD like mood disorders, sleep disorders, substance use and medical illnesses, such as thyroid disease or head injuries. These conditions are more likely to respond to certain treatments. It is therefore crucial to make a correct diagnosis and to receive the right treatment.
To be able to be diagnosed with ADHD, a child or an adult must meet a number of requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must display symptomatic behavior in two or more environments, like home, school and at work, and the symptoms must significantly interfere with their daily functioning. Generally, the symptoms must begin in the early years of childhood. A psychiatrist must confirm that the disorder isn't caused by a mental illness or comorbidity.