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Diagnosis of Attention-Deficit/ Hyperactivity Disorder (ADHD)

ADHD is diagnosed based on a clinical assessment performed by a mental health professional, usually a psychologist, pediatrician or psychiatrist. Especially in the case of children, this assessment involves an interview with the child and his or her family, and information from school teachers is often obtained. The goal of this assessment is to determine whether the patient meets the clinical criteria for ADHD

There are no laboratory tests or imaging tests (such as CT scans or MRI scans) that can help make a diagnosis of ADHD.

In some cases it can be difficult to differentiate ADHD from Bipolar Disorder, especially in children and adolescents. For some suggestions on how to tease apart these two conditions, see here.

Sometimes, clinicians may use scales and questionnaires to help identify ADHD and to document the severity of the symptoms.  Thorough reviews of the various scales available for children and adults should be consulted for further information [ref, ref]. Some of the more commonly used scales include:

The Conner's 3 ADHD/ DSM-IV Scales (CADS) are a set of self-report questionnaires for identifying and measuring ADHD symptoms in children and adolescents. There is one version that is given to the parents, one to the teachers, and one that adolescents can complete themselves.

The Vanderbilt Assessment Scales measure ADHD and several other behavioral conditions in children and adolescents, and include a parent and teacher version.

The Wender Utah Rating Scale (WURS) is a questionnaire that can be given to adults to detect whether they suffer from ADHD based on what they recall from symptoms they may have experienced in childhood. A score above 36 differentiates individuals with ADHD from those without the condition, but a score above 46 will also differentiate them from people suffering from Depression. The WURS is sensitive in detecting ADHD, but it may misclassify close to half of those who do not have ADHD [ref]. There is also no data on how well this instrument would differentiate ADHD from Bipolar Disorder. Note that only 25 of the 61 items are actually scored.

The Adult ADHD Self-Report Scale (ASRS-v1.1) is another self-report questionnaire that can be used to screen for ADHD in adults. It asks respondents to rate the symptoms that they may have experienced in the past 6 months. This instrument is designed not to make a diagnosis of ADHD, but to serve as a cue for clinicians to explore the issue further with those individuals who report numerous symptoms.

Symptoms & Definition