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ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults who are diagnosed with the disorder, identifying ADHD requires a thorough evaluation by a professional who specializes in the disorder. They'll likely inquire about your history and conduct a physical examination. They will also look for conditions that can mimic ADHD such as mood disorders, learning disorders, or thyroid conditions.
The doctor will ask you about your childhood behaviors, since the American Psychiatric Association's guidelines state that ADHD in adults can't be diagnosed without evidence of childhood symptoms. This may include obtaining your school records and contact with your former teachers and coaches or religious leaders.
Symptoms
You could have ADHD if you or someone you love is having trouble keeping up at school, work or at home. If they are unable to remember important dates or appointments or aren't able to keep track of important dates or appointments, then you might be suffering from ADHD. A visit to a health care provider can help you determine if this is the case, and If it is the case, what treatments are available.
The symptoms have to be present in at least two settings (school and at home, for instance) and for at least six months to satisfy the criteria for an ADHD diagnosis. The symptoms should also be hindering your ability to function for example in class, developing close relationships or working in a group. It's important to understand that everyone struggles with paying attention and staying organized at times, but these problems are more serious with ADHD.
Your doctor will ask questions about your behavior and how it has impacted your life. The doctor will also review your family history and any previous medical or psychological tests you've taken. They will be looking for health issues such as thyroid issues and seizure disorders that could cause the similar symptoms as ADHD.
Your provider will want to know if your symptoms started in your childhood (technically at the age of 12). Your provider will also be interested in knowing how your symptoms affect you at the moment and in the past. They'll also be looking to find out whether you've been diagnosed with ADHD before.
It's a good idea to bring your own list of symptoms to your appointment, particularly if you've written them down. This will help you recall your symptoms and provide your doctor a complete picture about how they impact you. You may also bring older records like old report cards or performance evaluations. These documents can help your doctor determine whether ADHD is a new issue or has been present for a long time. These records can help your provider rule other problems out including anxiety and depression that share similar symptoms to ADHD.
History
In the past, ADHD has been viewed as a character flaw. With the advancements in diagnosis and treatment, more children are diagnosed and the stigma surrounding the disorder is slowly fading.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He outlined his observations regarding children who were unable to pay attention or who were unable to focus. He also observed that the symptoms were more prevalent in boys than girls, and that they were not related to the home environment or intelligence. adult diagnosis of adhd is often credited as the beginning of official recognition of ADHD.
The first edition 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 became the preferred treatment for ADHD. The APA published its second edition in 1968, which listed a number of mental health conditions. It included the symptoms of ADHD, although they were still classified as hyperkinetic reaction of childhood.
The release of the fourth edition of the psychiatric manual 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 presentations, rather than distinct types, and states that they can change throughout a person's life.
NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults in 2008. This was the first time that the UK as an entire recognized adults suffering from ADHD, providing them with healthcare, funding, support and guidance. SIGN (Scottish Intercollegiate Guidelines Network), has also released 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 produced guidance. In recent years there has been a growing interest in the biological cause of ADHD. Researchers have begun to discover the genes responsible. This information can help develop better, more targeted treatments in the future.
Physical Examination
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 a doctor trained in child and young health (a paediatrician) They will want to gather a variety of details about the patient's life, including the family, educational, work and social history. They might review old school records or interview coaches, teachers and other professionals who know the person. They will inquire about symptoms and how they interfere with life. They will also look at how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, outlines the criteria used to diagnose 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. A specific questionnaire adapted to the situation will be administered by the specialist to talk to the patient about their symptoms. They also employ various rating scales to evaluate various aspects of ADHD symptoms. Some of these ratings will be built on the Brown Attention Deficit Disorder Symptom Assessment Scale For Adults while others will be based on different criteria, such as "Do you find it difficult sitting still?" and "Do you find it hard to manage your work or activities?"
They will conduct a physical examination. They will look for medical conditions that could be creating the symptoms or causing them to get worse, such a thyroid dysfunction or hearing or vision problems. They will also ask about the individual's diet and lifestyle habits to determine if they could be contributing to the symptoms.
Anyone who is being assessed for ADHD as an adult will likely be asked to fill out a questionnaire together with their partner or a close friend. This allows for a deeper understanding of the individual that checklists and questionnaires do not provide. This can be particularly useful for those suffering from comorbid disorders like anxiety or depression, which often co-occur with ADHD and make the symptoms more difficult to recognize.
Psychological Evaluation
A health professional who is evaluating a child for ADHD will ask them a series questions about the symptoms and how they impact their daily life. They also go over the patient's mental health as well as family history.
They usually ask the person to bring in report cards and school records to review, specifically those from kindergarten to high school. They may also request copies of prior tests, such as neuropsychological or psychological such as IQ tests and results from assessments for learning disabilities.
A psychologist, psychiatrist or social worker typically is the person who conducts the interview portion of an adhd diagnostic evaluation. They may also interview family members, friends and teachers as well as employers. It is crucial to conduct a comprehensive evaluation because people who are not treated for ADHD are susceptible to serious issues such as financial issues (impulsive spending) and marital problems, as well as failing in college or other educational institutions.
During the interview, the provider will typically request that the patient complete the standard behavior rating scales developed to help identify ADHD symptoms. These questionnaires are based on research that compares behaviors of those with ADHD and those who do not suffer from the disorder. These scores do not constitute a diagnosis of ADHD however they are an important part of the evaluation process.
It is crucial to examine the person to determine if there are other conditions that may be similar to ADHD. These include sleep disorders, mood disorders and substance abuse, and medical conditions such as thyroid disease or brain injuries. Those conditions are more likely to respond to specific treatments, so it is important to make sure that a valid diagnosis is made and that the correct treatment is given.
A person of any age must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptomatic behavior in at least two settings, such as home, school, and work. The symptoms must substantially affect the way they live of their lives. Generally, the symptoms must have started in childhood, and a psychiatric provider must determine that the disorder isn't caused by another mental illness or comorbid condition.
