ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults suffering from ADHD require a thorough evaluation by a specialist who is knowledgeable about the disorder. They will likely ask you about your history and conduct physical examination. They'll also rule out any conditions that may be similar to ADHD such as mood disorders, learning disorders, or thyroid disorders.
The doctor will ask you about your childhood behavior as the American Psychiatric Association's guidelines stipulate that ADHD in adults is not diagnosed without evidence of symptoms from childhood. This could include obtaining your school records and getting in touch with former teachers, coaches, or religious leaders.
Symptoms
You could be suffering from ADHD in the event that you or someone you love is struggling to keep up at school, work or at home. If they're unable to remember important dates or appointments or aren't able to stay organized it is possible that they are suffering from ADHD. A health care professional's assessment will help you determine if this is the case, and, if so what your treatment options are.
The symptoms must be present in at least two settings (school and at home, for example) and for at least six months in order to be able to qualify for an ADHD diagnosis. The symptoms must also be impacting your ability to perform for example in class, forming close relationships or in working in a team. It's important to understand that everyone has problems paying attention and staying well-organized at times, but these problems are more serious with ADHD.
To determine 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've had. They will also look for health problems, like thyroid disorders and seizures, which can cause similar symptoms to ADHD.
Your provider will ask whether you've had symptoms in childhood (technically before the age of 12). Your provider will also want to know how your symptoms are affecting you now and in the past. They'll also be looking to find out if you've ever been diagnosed with ADHD before.
It's helpful to bring a list of symptoms to the appointment, especially if you've written them down. This will aid in remembering them and give your physician a an accurate description of how your symptoms impact you. You can also bring older records like old report cards or performance evaluations. These records can help your provider determine whether ADHD has been a problem throughout your entire life or began recently. They can also help your provider determine if you have other issues like depression or anxiety, which often have similar symptoms to ADHD.
History
In the past, ADHD has been viewed as a character flaw. With the advancements in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma associated with the disorder is slowly fading.
In 1902, Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He described his observations about children who were inattentive or incapable of concentrating. He also observed that these symptoms were more prevalent in boys than girls, and were not correlated with the home environment or intelligence. Still's report is often credited with the first formal recognition of ADHD.
The initial version of the psychiatric handbook, released in 1952 by the American Psychological Association (APA), did not include ADHD. In 1955, however, the US FDA approved stimulant drugs which were prescribed as the primary treatment for ADHD. In 1968 the APA released its second edition which included a variety of mental health disorders. The second edition of the APA's manual included a variety of mental health issues, including ADHD symptoms.
With the release of the fourth edition of the manual for psychiatric patients in 1994, there was an increase in acceptance and understanding 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 as presenting symptoms, not distinct types, and states that they could change over a person's life.
NICE (National Institute for Clinical Excellence) has released guidelines on ADHD in adults in 2008. This was the first time the UK as a whole recognised with healthcare support as well as guidance and funding for adults who had ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued guidance on ADHD in children. These two documents are the sole official NHS Scotland recommendations on the condition. Private organisations and charities have also issued guidance. In recent years there has been a rise in interest in the biological causes of ADHD. Researchers have started to identify the genes that cause ADHD. This knowledge will help in the future to develop more specific and effective treatments.
Physical Exam
An expert in ADHD conducts a thorough evaluation to establish the diagnosis. It doesn't matter if they are a physician who specializes in mental health (such as a psychiatrist or psychologist) or a doctor who is also educated in the field of child and youth health (a paediatrician) They will want to gather information about the person's history that includes education, family, and social history. They might review old school records or interview coaches, teachers, and other professionals that know the person. They will ask questions about symptoms, and how they impact 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, outlines the criteria for determining 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 person regarding their symptoms using an assessment that is adapted to the specific situation. They may also employ different rating scales to evaluate different aspects ADHD symptoms. Some of these ratings are basing on the Brown Attention Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a variety of other criteria. They include questions like "Do you often have trouble sitting still?" Do I Am Psychiatry struggle with organizing your time or activities?
They will conduct a physical examination. They will look for medical conditions that may be causing the symptoms or causing them to become worse, such as thyroid dysfunction or hearing or vision issues. They will also ask about the person's dietary and lifestyle habits to determine if they could be contributing to the symptoms.
Someone who is being evaluated for ADHD as an adult may be asked to fill out the questionnaire with their partner or another close friend. This allows for a deeper understanding of the person than checklists and questionnaires can't provide. This is especially useful for people who have co-occurring conditions such as anxiety or depression. These often co-occur along with ADHD which makes it difficult to discern the signs.
Psychological Evaluation
If a health care professional evaluating a child or adult for ADHD begins by interviewing them, they ask a series of questions on how the symptoms impact their daily lives. They also go over a patient's mental health and family history.
They could request copies of the student's reports or school records, specifically those from kindergarten to high school. They can request copies of any previous tests, such as neuropsychological or psychological such as IQ tests and results from assessments for learning disabilities.
A psychiatrist, psychologist or social worker typically will conduct the interview portion of an adhd diagnostic evaluation. In addition, they could interview relatives, friends and teachers, as well. It is crucial to conduct a comprehensive evaluation because people who suffer from untreated ADHD may have serious issues that include financial issues (impulsive spending) or marital issues, as well as failing in college or other educational institutions.
During the interview, the doctor will often request that the patient complete the standard behavior rating scales developed to detect ADHD symptoms. These tests are based on research that compared the behavior of people suffering from ADHD and those who do not suffer from the disorder. These ratings are not an official diagnosis of ADHD but they are an important part of the assessment process.
It is also important to examine the person to determine if there are other conditions that may have similar symptoms as ADHD. These include sleep disorders, mood disorders and substance abuse as well as medical illnesses like thyroid disease or brain injuries. These conditions are more likely to respond to certain treatments, therefore it is essential to make sure that a valid diagnosis is made and that the appropriate treatment is provided.
To be diagnosed with ADHD, the child or adult must meet the requirements in the Diagnostic and Statistical Manual of Mental Disorders. They must display symptoms in at least two different settings, such as school, home, and work. The symptoms must also substantially affect the way they live of their lives. The symptoms must first be noticed in childhood, and a psychiatrist must verify that the disorder was not caused by mental illness or other concomitant conditions.