ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults who are diagnosed with the disorder, identifying ADHD requires a thorough evaluation by a specialist who is trained in the disorder. They'll likely ask about your history and do an examination. They will also rule out any conditions that may be similar to ADHD such as mood disorders, learning disorders or thyroid disorders.
The doctor will also ask about your childhood habits as current American Psychiatric Association guidelines state that adult ADHD cannot be diagnosed without evidence of symptoms from childhood. This includes 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 school, work or at home, is having difficulties remembering important dates and appointments, or is struggling to stay organized or stay on top of things, you could be suffering from ADHD. A health care provider's evaluation can 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 different environments (school and at home, for example) and for at least six months to be able to qualify for an ADHD diagnoses. The symptoms must also be affecting your ability to function for instance in class, developing close relationships or working as part of a team. It's crucial to understand that everyone has difficulty staying focused and organized at times, but these problems are more severe with ADHD.
In order to make an assessment, your doctor will interview you and ask you questions about your behavior and how it's affected your life. The doctors will also look at your family history, as well as any previous psychological or medical tests that you may have taken. They will check for health issues, like thyroid disorders and seizure disorder, which can cause similar symptoms as ADHD.
Your doctor will ask you if you have ever had symptoms in your childhood (technically before age 12). They'll also be interested in how your symptoms affect you today and how they've affected you in the past. They'll also be interested in knowing if you've ever been diagnosed with ADHD before.
Bring your own list of symptoms, especially if they're written down. This will help you remember them and give your physician a an accurate description of the way your symptoms affect you. You can also bring older records like old reports or performance evaluations. These records can help your doctor determine whether ADHD has been a problem throughout your entire life or started just recently. They can also help your doctor identify other conditions, such as anxiety or depression which can have the same symptoms as ADHD.
History
In the past, ADHD was thought to be a character flaw or lazyness. With advancements in diagnosis and treatment, more children are diagnosed and the stigma around 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 inattentive or incapable of concentrating. He also observed that the symptoms were more prevalent for boys than girls and were not related to the quality of education or home environments. The report is often credited with the first the formal recognition of ADHD.
The first edition of the psychiatric manual published in 1952 by the American Psychological Association (APA) did not include ADHD. However, in 1955 the US FDA approved a stimulant drug that became the preferred treatment for ADHD. The APA published its second edition in 1968, which listed several mental health conditions. The second edition of the manual listed a number of mental health conditions, including ADHD symptoms.
In 1994, the fourth edition of the 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 presenting symptoms, not distinct types, and states that they could change over a person's life.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. It was the first time that the UK as an entire recognized adults with ADHD and provided them with funding, healthcare assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued advice on ADHD in children. These two documents are the only official NHS recommendations regarding the condition in Scotland. Private and non-profit organizations have also produced guidance. In recent years, there has been an increasing interest in the biological causes of ADHD. Researchers have begun to find the genes responsible. This knowledge may help to develop better targeted, more effective treatments in the future.
Physical Examination
An expert in ADHD conducts a thorough assessment to establish a diagnosis. If they are a doctor who is specialized in mental health (such as a psychiatrist or psychologist) or a doctor trained in child and young health (a paediatrician), they will want to gather 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 symptoms and how they impact life. They will also examine how symptoms have changed with time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, lays out 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 usually interview the patient about their symptoms using the appropriate questionnaire to the specific circumstance. They may also employ different scales of assessment which examine 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 other factors, including questions such as "Do you find it difficult sitting still?" and "Do you have difficulty to manage your work or activities?"
They will perform a physical exam. They will check to see if there are any medical problems which could be responsible for making the symptoms worse, such as thyroid dysfunction or vision and hearing problems. They will also inquire about the person's dietary and lifestyle habits to determine if they might be contributing to the symptoms.
If a person is being assessed for ADHD in adulthood, they will be asked to fill out an assessment with a partner or a close friend. This provides a deeper understanding of the person that checklists and questionnaires do not provide. This is particularly beneficial for those suffering from comorbid disorders such as depression or anxiety, which often co-occur with ADHD and make the symptoms more difficult to identify.
Psychological Evaluation
A health care professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they affect their daily life. They also look over the patient's mental health and family history.
They usually ask people to bring in report cards and school records for review, specifically those from kindergarten to high school. They may also ask for copies of any previous neuropsychological or psychological testing, such as results from IQ tests and learning disabilities assessments.
A psychiatrist, psychologist or social worker typically conducts the interview portion of an adhd diagnostic assessment. They may also conduct interviews with relatives, friends and teachers as well as employers. It is crucial to conduct a comprehensive evaluation because people with untreated ADHD may have serious issues, including financial issues (impulsive spending), marital difficulties or failure at college or other educational institutions.
During an interview, a doctor might ask the patient to complete standardized behavioral ratings scales that are designed to identify ADHD symptoms. These questionnaires are based upon research that compares the behaviors of people with ADHD with those of those without the disorder. These ratings are not a diagnosis of ADHD but they play an important part in the process of evaluating.
It is crucial to assess the individual to determine if there are other conditions that might exhibit similar symptoms to ADHD. These include sleep disorders, mood disorders, and addiction to drugs, as well as medical illnesses like thyroid disease or brain injuries. Those conditions are more likely to respond to specific treatments, so it is crucial that a correct diagnosis is made and the correct treatment is given.
To be diagnosed with ADHD, the child or adult must meet the requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must show symptomatic behavior in two or more environments like school, home and at work, and the symptoms must seriously affect their daily functioning. Typically, adhd adult diagnosis must be present since the early years of childhood. A psychiatrist must be able to determine that the disorder isn't caused by another mental illness or comorbidity.