ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults diagnosing ADHD requires a thorough assessment by a specialist in the disorder. They'll likely ask you about your history and conduct physical examination. They'll also rule out other conditions that could be a cause of ADHD, such as mood disorders, learning disorders or thyroid conditions.
The doctor will also inquire about your childhood behaviors as current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of symptoms from childhood. This includes getting school records and contacting former teachers, religious leaders or coaches.
Symptoms
If you or a loved one is having trouble keeping up with school, work or at home, and has difficulty remembering important dates or appointments, or can't seem to get organized, you may have ADHD. A health professional's assessment can help you determine if this is true and, if it is what the treatment options are.
The symptoms have to be present in at least two environments (school and at home, for instance) and for at least six months to meet the criteria for an ADHD diagnosis. They should also significantly interfere in your ability to function in some ways, such as doing well in school, developing close relationships, or functioning as a member of a team. It's important to realize that everyone struggles with paying attention and staying well-organized at times, but these problems are more severe for those with ADHD.
Your doctor will ask you questions about your behavior, and how it has affected your life. The doctor will also review your family history, and any previous medical or psychological tests you've taken. They will look for health problems such as thyroid issues and seizure disorders, that can cause the same symptoms as ADHD.
Your doctor will inquire whether you've ever experienced symptoms in childhood (technically before age 12). They'll also want to know how your symptoms affect you today and how they've affected you in the past. They'll want to know if you've been diagnosed with ADHD in the past.
Bring your own list of symptoms, particularly when they are written down. This will help you keep track of your symptoms and give your doctor a complete picture of how they affect you. You may also bring in old records, such as old report cards or performance evaluations. Having these documents can help your doctor determine whether ADHD has been a problem throughout your whole life or only started just recently. These documents can help your doctor to rule out other conditions, such as depression and anxiety that have similar symptoms as ADHD.
History
In the past, ADHD was thought to be a flaw in character or lazyness. With advancements in diagnosis and treatment more children are being diagnosed and the stigma around the disorder is slowly fading.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He described his observations of children who were irritable and unfocused. He also observed that the symptoms were more prevalent in boys than girls, and that they were not related to the quality of education or home environments. Still's report has been considered to be the first step towards the formal recognition of ADHD.
The first version of the APA's mental health guideline, released in 1952, did not mention ADHD. However, in 1955, the US FDA approved stimulant drugs that became the preferred treatment for ADHD. In 1968 the APA published its second edition which listed a number of mental health issues. The second edition of the manual listed several mental health conditions, including ADHD symptoms.
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 views these as presentations, rather than distinct types and states that they may change over the course of a person's lifetime.
In 2008, NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults. This was the first time that the UK as an entire recognized adults with ADHD and provided them with funding, healthcare support and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also released guidelines on ADHD among children. These two documents are the only official NHS Scotland guidelines on the condition. Other guidance has been developed by charities and private organizations. In recent times there has been an increase in interest in the biological causes of ADHD, and researchers have begun to discover the genes that cause it. This information can help create better targeted, more effective treatments in the future.
Physical Exam
A specialist in ADHD will conduct a thorough evaluation to identify the problem. They collect data from the patient's past, including their family, education and employment history, as well as their social history. They will go through the school records from the past and interview coaches, teachers, and other professionals who know the person. They will ask about the symptoms and how they interfere with life. They will also consider how symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, defines the criteria used to diagnose 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. The specialist will typically interview the patient about their symptoms using an assessment that is adapted to the specific situation. They will also use a variety of rating scales that look at different aspects of ADHD symptoms. Some of these ratings will be basing on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults while others will be based on different factors, including questions such as "Do you find it difficult to sit still?" and "Do you have difficulty to manage your activities or work?"
They will perform an examination of the body. They will look for medical conditions that may be creating the symptoms or causing them to become worse, such a thyroid dysfunction or hearing or vision problems. They will also inquire about the person's diet and lifestyle habits to determine if they might be contributing to the symptoms.
Someone who is being assessed for ADHD as an adult will likely be asked to complete the questionnaire with their partner or another close friend. This can help uncover personal insights that questionnaires and checklists in no way able to provide. This can be particularly useful for those suffering from comorbid disorders such as depression or anxiety which are often associated with ADHD and make the symptoms harder to recognize.
Psychological Evaluation
A health professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they affect their daily lives. They also go over the patient's mental health and family history.
They can request an original copy of the student's report card or school records, specifically those from kindergarten through high school. They can also request copies of prior tests for neuropsychology or psychological which include IQ tests and results from assessments of learning disabilities.
A psychiatrist, psychologist or social worker usually conducts the interview part of an adhd diagnostic assessment. They may also conduct interviews with family members, friends and teachers as well as employers. It is crucial to conduct a comprehensive evaluation because people who suffer from untreated ADHD are susceptible to serious issues, including financial issues (impulsive spending) or marital issues, as well as failure in college or other educational institutions.
During adhd diagnosed , the provider might ask the patient to fill out standardized behavior ratings scales that are designed to detect ADHD symptoms. These tests are based on research that compares the behavior of people with ADHD to those of individuals who do not suffer from the disorder. These scores do not constitute a diagnosis of ADHD but they are an important element of the assessment process.
It is also essential to examine the patient for other conditions that could exhibit similar symptoms to ADHD like sleep disorders, mood disorders, substance use disorders and medical illnesses, such as head injuries or thyroid disease. These conditions are more likely than other conditions to respond to certain treatments. It is therefore important to determine the correct diagnosis and get the appropriate treatment.
A child or adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behaviors in at least two settings that include school, home, or work. The symptoms must substantially affect the way they live of their lives. The symptoms must have manifested in childhood and a psychiatrist must verify that the disorder was not caused by an illness of the mind or other comorbid conditions.