ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough assessment by a doctor who is familiar with the disorder. They'll likely inquire about your medical history and conduct an examination. They'll also rule out conditions that can mimic ADHD such as learning disorders, mood disorders, or thyroid issues.
The doctor will inquire about your childhood behavior, since the American Psychiatric Association's guidelines state that ADHD in adults cannot be diagnosed absent evidence of early signs. This means obtaining school records and contacting former teachers, religious leaders, or coaches.
Signs and symptoms
You may have ADHD if you or someone you love has trouble keeping track of time at work, school or at home. If they can't remember important dates or appointments, or cannot keep their schedules in order, then you might be suffering from ADHD. A health care provider's evaluation can help you determine if this is the case and if so what the treatment options are.
To qualify for an ADHD diagnosis the symptoms must be present for at least 6 months and be apparent in at least two different settings (school and home, for example). They should also seriously interfere in your ability to function in some ways, such as doing well in school, developing close relationships, or functioning on teams. It is important to recognize that everyone has difficulty staying organized and paying attention at times, but these problems are more severe with ADHD.
In order to make a diagnosis, your provider will interview you and ask questions about your behavior and how it has affected your life. The doctor will also look over your family history as well as any previous psychological or medical tests you may have had. They will look for health problems, such as thyroid disorders and seizures, which could cause similar symptoms as ADHD.
Your doctor will want to be aware of whether your symptoms began in your childhood (technically prior to age 12). Your doctor will also be interested in knowing what your symptoms are doing to you right now and in the past. They'll want to know if you've been diagnosed with ADHD in the past.
Bring your own list of symptoms, especially if they're written down. This will allow you to recall your symptoms and provide your doctor a complete picture of how they impact you. You may also bring 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 was diagnosed just recently. They can also help your doctor determine if you have other issues like depression or anxiety, which often have the same symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. But, with advancements in diagnosis and treatment more children are being diagnosed, and the stigma surrounding this disorder is slowly disappearing.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He outlined his observations regarding children who were inattentive or who were unable to focus. He also observed that the symptoms were more prevalent in boys than girls and were not related to the home environment or intelligence. Still's report has been credited as the first official recognition of ADHD.
The first edition of the psychiatric manual 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. The APA published its second edition in 1968, and included a variety of mental health issues. It included symptoms of ADHD even though they were still called 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 considers these to be presentations rather than distinct types and states that they are able to change over time.
In 2008, NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults. It was the first time that the UK as a whole recognized adults with ADHD, providing them with financial aid, healthcare assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidance on ADHD in children. These two documents are the sole official NHS guidelines regarding the condition in Scotland. Other guidelines have been created by private companies and charities. In diagnosed with adhd there has been an increase in interest in the biological causes of ADHD and researchers have begun to find the genes responsible for it. This knowledge could help in the near future in developing more targeted and better treatments.
Physical Exam
A specialist in ADHD conducts an extensive assessment to establish a diagnosis. It doesn't matter if they are a physician who is specialized in mental health (such as a psychiatrist or psychologist) or an individual doctor who is educated in the field of child and youth health (a paediatrician) They will want to gather a variety of details about the person's past including education, family, and social histories. They might review the old school records, or speak with coaches, teachers and other professionals who know the person. They will ask questions about 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 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 person about their symptoms using an assessment that is adapted to the specific situation. They will also use different rating scales to evaluate different aspects ADHD symptoms. Some of these ratings are based on the Brown Attention-Deficit Disorder Symptom Assessment Scale for Adults, while others are based on a variety of other criteria. They include questions like "Do you have difficulty sitting down?" Do you have trouble organizing your work or activities?
They will conduct a physical exam. diagnosed with adhd will check to see if there are any medical problems which could be responsible for aggravating the symptoms, such as thyroid dysfunction or vision or hearing issues. They will also ask about the person's dietary and lifestyle habits to determine if they could be contributing to the symptoms.
If a person is assessed for ADHD in adulthood the person will be asked to complete the questionnaire with their partner or a close family member. This will allow for a greater understanding of the person than checklists and questionnaires can't provide. This is particularly beneficial for people who have comorbid conditions like anxiety or depression. These often co-occur along with ADHD, making it difficult to identify the signs.
Psychological Evaluation
When a health care professional who is evaluating a child adult for ADHD begins by interviewing them, they ask them a series of questions regarding how the symptoms affect their daily lives. They also look over a patient's mental health and family history.
They may ask for an original copy of the student's report cards or school records, specifically those from kindergarten through high school. They might also request copies of any previous psychological or neuropsychological testing, such as results from IQ tests and assessments for learning disabilities.
Typically the psychologist, psychiatrist or social worker will conduct the interview part of an evaluation of the severity of adhd. Additionally, they may interview family members, friends, teachers or employers as well. It is essential to have thorough evaluations because those with untreated ADHD can experience serious problems that include financial issues (impulsive spending) or marital issues, as well as failure at colleges or other educational institutions.
During the interview, a doctor will usually ask the patient to complete standardized behavior rating scales that are designed to identify ADHD symptoms. These questionnaires are based upon research that compares the behavior of people with ADHD to those of people without the disorder. These ratings are not an official diagnosis of ADHD but they are an important element of the evaluation process.
It is also essential to check the person for other conditions that could exhibit similar symptoms to ADHD like sleep disorders, mood disorders, substance abuse and medical conditions, like head injuries or thyroid disease. These conditions are more likely than others to respond to specific treatments. It is therefore important to determine the correct diagnosis and to get the appropriate treatment.
A person who is a child or an adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptoms in at least two different settings, such as school, home, or work. The symptoms should also severely hinder the normal functioning of their lives. The symptoms must have manifested in childhood, and a psychiatrist must confirm that the disorder wasn't caused by mental illness or other comorbid conditions.