ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults diagnosing ADHD requires a thorough examination by a specialist in the disorder. They'll likely ask about your medical history and conduct an examination. They'll also rule out other conditions that may resemble ADHD, such as learning disorders, mood disorders, or thyroid problems.
The doctor will ask you about your childhood behaviors, because the American Psychiatric Assocation's guidelines state that ADHD in adults cannot be diagnosed without evidence of symptoms from childhood. This could include finding school records and getting in touch with former teachers, religious leaders, or coaches.
Symptoms
If you or a loved one is having trouble keeping up at work, school or at home, is having difficulties remembering important dates and appointments, or is unable to get organized it could be that you suffer from ADHD. A health care professional's assessment will help you determine if this is true and, if so, what treatment options there are.
The symptoms must be present in at least two environments (school and at home, for example) and for at least six months in order to satisfy the criteria for an ADHD diagnosis. They must also be a major obstacle with your ability to function in some ways, such as performing well in class, developing close bonds, or working in teams. It's important to understand that everyone has issues paying attention and staying organized at times However, these issues are more serious for those with ADHD.
To determine a diagnosis, your provider will conduct an interview and ask you questions about your behavior and how it has affected your life. Providers will also review your family history as well as any previous medical or psychological tests you've taken. They will be looking for health issues like thyroid issues and seizure disorders, that can cause the similar symptoms as ADHD.
Your doctor will inquire whether you've ever experienced symptoms during your childhood (technically before age 12). Your doctor will also want to know what your symptoms are doing to you right now and in the past. They'll also be interested in knowing if you've ever been diagnosed with ADHD before.
It's a good idea to bring a list of symptoms to the appointment, particularly when you've written them down. This will help you to remember your symptoms and give your doctor a complete picture about how they impact you. You may also bring other records, such as performance evaluations from work or old school report cards. These documents can help your doctor determine whether ADHD is a recent issue or has been present for a long period of time. These records can help your provider rule other problems out like depression and anxiety that share similar symptoms to ADHD.
History
In the past, ADHD was thought to be a personality flaw or lazyness. With advancements in diagnosis and treatment more children are being diagnosed and the stigma associated with the disorder is slowly fading.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He described his observations about children who were unable to pay attention or incapable of concentrating. He also observed that these signs were more common in boys than in girls and were unrelated to the home environment or intelligence. Still's report is often credited with the first the formal recognition of ADHD.
The first edition of APA's psychiatric guide, published in 1952, did not mention ADHD. In 1955, however, the US FDA approved stimulant drugs that was the most popular treatment for ADHD. how to diagnose adhd released its second edition in 1968, which included a variety of mental health issues. It included symptoms of ADHD however they were still classified as hyperkinetic reaction in childhood.
The release of the fourth edition of the manual for psychiatric patients in 1994, there was an increase in 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 manifestations rather than distinct types and states that they can change over time.
In 2008, NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults. This was the first time the UK as a whole recognized with support from healthcare and guidance for adults who had ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the only official NHS Scotland guidelines on the condition. Private and non-profit organizations have also produced guidance. In recent years 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 information could help develop better targeted, more effective treatments in the near future.
Physical Exam
An expert in ADHD conducts an extensive assessment to determine if they have the diagnosis. If they are a doctor who is specialized in mental health (such as a psychologist or psychiatrist) or an individual doctor who is trained in child and young health (a paediatrician), they will want to gather a variety of information about the person's history including the family, educational, work and social histories. They might look over the old school records, or speak with teachers, coaches and other professionals who know the person. They will inquire about the symptoms and how they interfere with life. They will also examine how the symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria for diagnosing ADHD in children and adults. 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 by using a questionnaire that is tailored to the particular situation. They may also employ different rating scales to look at various 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 have difficulty sitting still?" Do you struggle with organizing your work or activities?
They will conduct a physical exam. They will check to see if there are any medical issues that might be causing or making the symptoms worse for example, thyroid dysfunction or vision or hearing issues. They will also ask the patient about their diet and lifestyle habits to determine if they could be contributing to the symptoms.
A person who is being assessed for ADHD as an adult is likely to be asked to fill out a questionnaire with their partner or close friend. This will help to gain the personal insights that checklists and questionnaires are unable to provide. This is particularly beneficial for people suffering from comorbid conditions like anxiety or depression that often co-occur with ADHD and make the symptoms more difficult to identify.
Psychological Evaluation
When a health professional who is evaluating a child adult for ADHD begins by interviewing them, they ask them a series of questions about how their symptoms affect their lives. They also take a look at the history of the patient's family and their mental health.
They could request a 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 such as IQ tests and results from assessments for learning disabilities.
Typically an audiologist, psychiatrist, psychologist or a social worker conducts the interview portion of an evaluation of the severity of adhd. They might also interview friends, family members as well as teachers or employers. It is crucial to have a an extensive assessment since people with ADHD who are not treated may face serious issues. These could include financial problems (impulsive purchases) and marital problems or failure at college or other educational institutions.
During the interview, the doctor will usually ask the patient to fill out standardized behavior rating scales designed to help identify ADHD symptoms. These questionnaires are based upon research that compared the behavior of people with ADHD and those without the disorder. These ratings are not a diagnosis of ADHD, but they are an important aspect of the assessment process.
It is also important to assess the individual to determine if they have other conditions that might have similar symptoms as ADHD. These include mood disorders, sleep disorders and substance abuse, as well as medical illnesses such as thyroid diseases or brain injuries. These conditions are more likely than other conditions to respond to certain treatments. It is therefore crucial to make a correct diagnosis and to get the appropriate treatment.
To be able to be diagnosed with ADHD, the child or adult must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders. They must display symptoms in more than one setting, like home, school and at work, and the symptoms must significantly interfere with their life functioning. The symptoms must have manifested in childhood, and a psychiatric professional must confirm that the disorder was not caused by an illness of the mind or other concomitant conditions.