Adult ADHD Diagnostic Assessment and Treatment
Many adults suffering from ADHD have a difficult finding a way to diagnose. Doctors need to assess whether symptoms are present today, and if they were present at different times in the course of their lives (technically at the age of 12).
A thorough assessment usually involves more than just one person. It is helpful to involve family members, colleagues and teachers.
Self-Assessment Tools
The most used self-assessment tool used by adults with ADHD is the Adult ADHD Symptom Self-Report Scale. Adults can complete it at home. It is accessible on the internet. This tool asks questions about symptoms commonly experienced by ADHD sufferers. This tool can be used as a preliminary step to determine if you need to seek further assessment by a healthcare professional.
Other symptom inventories for adults include the BADDS42, the AD/HD Symptom Inventory for Adults (AD/HD-IS) and the CAARS44. The BADDS is a 40-item measurement that contextualizes ADHD symptoms in real-life situations it is a 40-item measure. It can be administered either by self-report or as an instrument evaluated by an observer. It also provides useful supplementary factors in addition to DSM-5 scales. Age-based norms are also provided.
These symptom inventories can be useful in the process of diagnosing ADHD because they offer a wider array of data than a single interview, however their low positive predictive value restrict them. They are also able to over-identify likely ADHD cases. This is due to the fact that many of the symptoms these tools evaluate are present in healthy individuals and are not specific to ADHD.
A diagnosis of ADHD is based on the presence and persistent symptoms in various situations over time. This requires a more in-depth assessment of the functioning from different angles, and the assessment of comorbidities, such as depression or substance use disorders. These disorders often co-occur with ADHD and can affect the quality of life for people living with these conditions.
Despite the limitations, self-assessment tools remain useful as a first screening test that could help a person recognize the possibility of having elevated levels of ADHD symptoms and should think about an evaluation by a doctor. This is especially important for a person with concerns that their symptoms could be affecting their daily life at the school, at work, or within their family.
In contrast to self-assessment instruments or self-assessment tools, interviews with an expert in the field of ADHD can give a more complete picture and more certainty in the diagnosis. They can draw upon a wide array of information that includes the results of neuropsychological testing and other performance-based measures, as in addition to anecdotal evidence gathered from a person's daily routine.
Diagnosis
A diagnosis of adult ADHD is only made by a licensed mental health professional with experience in conducting such assessments. While online tools such as self-tests and rating scales can give a clue as to the possibility that your symptoms could be caused by ADHD but they are not able to give you an exact diagnosis.
A professional ADHD assessment involves a thorough interview as well as information from other sources like a spouse or a family member, and standardized psychometric tests. A thorough evaluation is designed to determine whether the individual's symptoms are severe enough to have an impact to cause impairment in two or more areas of their lives. Impairment can include getting fired from a job, enduring financial difficulties due to not paying bills on time, or having conflict and distress in relationships.
In the interview, it is essential that the patient discusses the symptoms in a candid manner and truthfully. Many people with ADHD are reluctant to talk about their issues because they are embarrassed by their issues or fear that others will judge them for having the disorder. It can be a challenge, but it is essential that a clinician have a complete picture of the person's life and the symptoms.
Diagnostic interviews that are structured can be used to assess adult ADHD. These interviews can reduce the reliance on DSM-based symptoms inventory which was created for children but does not always translate well for adults. Adult ADHD inventories as well as executive function inventories and impairment/quality-of-life ratings are all useful tools in the evaluation process. They permit the clinicians to keep track of the patient's progress throughout treatment.
Ask your primary care doctor for an appointment with a local professional who specializes in the diagnosis of adult ADHD. You can also get a referral through your insurance company, call an academic hospital or your local psychology association for help in finding a qualified professional. If you're having difficulty finding someone within your area, you can also call a national company that offers phone or video consultations to connect you to a specialist. These services can be an inexpensive way to get the help you need today.
Treatment
Adults who suffer from ADHD may have difficulties at home, work and in their relationships. Inattention, disorganization, and issues with impulsivity can impact self-esteem and social performance leading to frustration and a feeling that things won't be perfect. It's important to find a specialist who is familiar with the difficulties of diagnosing and treating adults suffering from ADHD.
In contrast to children, adults have to be able to demonstrate higher levels of symptoms to be diagnosed. Adults have to show chronic, severe problems in a variety of areas of their lives. It is also crucial to take a complete medical history, as some diseases have similar symptoms to ADHD like thyroid disorders, seizures, issues with vision or hearing. Additionally, certain drugs and medications can cause ADHD-like symptoms.
Structured diagnostic interviews can assist clinicians in confirming the symptoms are ADHD and not a different neurodevelopmental disorder or psychiatric issue. This can include asking about the patient's education, work and family history. The clinician can also ask about the use of alcohol and drugs as well as the current and past use and any other health issues, such as a sleep disorder or problems with vision or hearing.
In addition to the structured interview, other tests could be used. These can include IQ and achievement tests, along with a variety of psychological or neuropsychological testing. These tests don't diagnose ADHD however they do provide valuable information on the effects of ADHD on an individual.
Once a diagnosis has been established, pharmacological and psychosocial treatment are often used to address the symptoms. These can be administered individually or in combination. For instance, a patient might be treated using cognitive behavioral therapy to help him identify and modify "thought distortions" and improve his ability to prioritize tasks and manage his time. ADHD medication can also be used to decrease the inattention and impulsiveness that make it difficult for people with ADHD to finish their school work or assignments.
It is advised that all adults with an onset diagnosis of ADHD or uncontrolled symptoms consult their healthcare provider within 30 days. Regular follow-ups are then suggested until symptoms and function have improved. It is essential that the health care professional monitors comorbid conditions such as depression and anxiety during treatment.
Support
Adults with ADHD might find help in many different ways. Some find comfort in online forums and peer support groups online such as those provided by ADDitude magazine. They can also connect with other people by attending meetings of local support groups, or at camps for kids, teens and adults suffering from ADHD. These groups offer support, resources, and guest speakers to assist with learning and coping skills.
Adults are more difficult to diagnose than children, and most of the self-assessment tools cannot provide a definitive diagnosis. The symptom guidelines in the DSM-V are designed to diagnose children, while an adult ADHD diagnosis is only made after an extensive clinical evaluation that includes structured diagnostic interviews and a range of objective measures. Tests for performance and neuropsychological testing are particularly useful for testing for executive functioning deficiencies. They permit a clinician to observe symptoms in action and give a more accurate picture of the severity of impairment than self-report instruments.
It is essential to interview other significant people in the patient's life like the spouse or partner, parents and siblings and employers. It can be difficult for those being assessed to open up and discuss their concerns. Adults suffering from ADHD may not be aware of the negative impact of their behavior on others.
A thorough assessment requires a careful review of the patient's background to identify mental and non-psychiatric disorders which could be the cause of the symptoms. It is not uncommon for people suffering from ADHD to be diagnosed with more than one disorder.
It is essential for adults with ADHD to have someone else complete questionnaires that evaluate their symptoms and impact on quality of life. This is because symptom ratings are subjective. IamPsychiatry must be a close family member or sibling who is familiar with the person and is able to confirm their observations. Some doctors require that a trusted co-worker or employer complete a similar questionnaire to get additional information that is not available during an interview with a clinician.