ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough assessment by a doctor who is well-versed in the disorder. They'll likely inquire about your history and perform an examination. They will also look for conditions that may be similar to ADHD such as mood disorders, learning disorders, or thyroid issues.
The doctor will also inquire about your childhood behavior as the current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of symptoms from childhood. This could mean getting your school records as well as contacting previous teachers or coaches as well as religious leaders.
Symptoms
If you or a loved one struggles to keep up at work, school, or home, has difficulty remembering important dates or appointments, or is unable to organize it could be that you suffer from ADHD. A health care professional's assessment will help you determine if this is the case, and if so, what treatment options there are.
The symptoms must be present in at least two settings (school and at home, for instance) and for at least six months to meet the criteria for an ADHD diagnoses. They should also seriously interfere with your ability to function in certain ways, like doing well in class, developing close relationships, or functioning on teams. It is important to recognize that everyone has issues paying attention and staying well-organized at times, but these problems are more serious for those with ADHD.
Your provider will ask you questions about your behavior and how it has impacted your life. The doctor will also look over your family history and any previous medical or psychological tests you may have had. They will look for health issues such as thyroid issues and seizure disorders that could cause the similar symptoms as ADHD.
Your doctor will want be aware of whether your symptoms began in childhood (technically at the age of 12). Your provider will also be interested in knowing how your symptoms are affecting you at the moment and in the past. They'll also want to know whether you've been diagnosed with ADHD before.
It's helpful to bring a list of symptoms to the appointment, especially when you've written them down. This will aid in remembering the symptoms and provide your doctor with a an accurate picture of how your symptoms affect you. You may also bring other records like the performance evaluations you receive from work or old school report cards. These records can help your provider determine if ADHD is a recent issue or has been present for a long time. These records can help your provider rule other problems out like anxiety and depression that have similar symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. With the advancements in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma associated with this disorder is diminishing.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He shared his observations of children who were inattentive and unfocused. He also noted that the symptoms were more common for boys than girls and were not related to the quality of education or home environments. Still's report has been credited as the beginning of the formal recognition of ADHD.
The initial version of the psychiatric manual, released in 1952 by the American Psychological Association (APA), did not include ADHD. But in 1955 the US FDA approved stimulant drugs that was the most commonly used treatment for ADHD. In 1968, the APA released its second edition that 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 the psychiatric book was published. 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 recognizes these as presentations rather than distinct types and says that they may change over time.
NICE (National Institute for Clinical Excellence) has released guidelines on ADHD in adults in 2008. I Am Psychiatry was the first time that the UK as an entire officially recognized adults with ADHD and provided them with healthcare, funding, assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued advice on ADHD in children. These two documents are the sole official NHS recommendations on the condition in Scotland. Private and non-profit organizations have also developed guidelines. In recent times there has been an increase in interest in the biological causes of ADHD, and researchers have begun to identify the genes responsible for it. This knowledge may help to create better, more targeted treatments in the near future.
Physical Exam
A specialist in ADHD will conduct a thorough evaluation to diagnose the condition. Whether they are a physician who specializes in mental health (such as a psychiatrist or psychologist) or a doctor trained in child and youth health (a paediatrician) They will want to collect a range of details about the patient's life including family, educational, work and social histories. They will review old school records and interview coaches, teachers and other professionals who know the person. They will inquire about the symptoms and how they affect life. They will also look at how symptoms have changed with time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, defines the criteria used to diagnose 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. A customized questionnaire to the situation will be utilized by the specialist to talk to the patient about their symptoms. They will also use a variety of rating scales which examine various aspects of the ADHD symptoms. Some of these ratings will be based on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults, while others will be based on different criteria, including questions like "Do you have difficulty sitting still?" Do you have trouble organizing your work or activities?
They will perform an examination of the body. They will look for medical conditions that could be causing the symptoms or causing them to become worse, like thyroid dysfunction or vision or hearing issues. They will also inquire with the patient about their diet and lifestyle habits in order to determine if these could contribute to symptoms.
Someone who is being assessed for ADHD as an adult may be asked to fill out the questionnaire together with their partner or a close friend. This allows for a deeper understanding of the person than checklists and questionnaires do not provide. This is especially beneficial for people with comorbid conditions like anxiety or depression that often co-occur with ADHD and make the symptoms harder to identify.
Psychological Evaluation
When a health care professional who is evaluating a child or adult for ADHD first interviews them, they ask them a series of questions about how the symptoms affect their lives. They also go over a patient's mental health and family history.
They could request copies of the student's report card or school records, especially those from kindergarten to high school. They can request copies of any previous tests, such as neuropsychological or psychological, including IQ tests and results from assessments for learning disabilities.
Typically an audiologist, psychiatrist, psychologist or a social worker conducts the interview portion in an evaluation of the severity of adhd. In addition, they might interview friends, family members, teachers or employers as well. It is important to get a comprehensive assessment because people who suffer from ADHD who are not treated may face serious issues. These could include financial problems (impulsive purchases) or marital issues, or failure at colleges or other educational institutions.
During the interview, the doctor will usually request that the patient complete standardized behavior rating scales that are designed to help identify ADHD symptoms. These questionnaires are based upon research that compares the behavior of individuals with ADHD to those of individuals without the disorder. These scores are not an official diagnosis of ADHD, but they are an important part in the process of evaluating.
It is crucial to examine the person to determine if they have other conditions that could exhibit similar symptoms to ADHD. These include mood disorders, sleep disorders, and addiction to drugs, as well as medical illnesses like thyroid disease or brain injuries. These conditions are more likely to respond to specific treatments, therefore it is important to make sure that a valid diagnosis is made and the correct treatment is given.
A person of any age 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 home, school, and work. The symptoms must significantly interfere with the functioning of their lives. Generally, the symptoms must have started in the early years of life, and a psychiatrist must confirm that the disorder isn't caused by another mental illness or comorbid condition.