Diagnosis and Assessment of Disease
ADHD Diagnos
Scree
>> As part of a mental health assessment, regardless of presenting complaint, ask parents/ca
causing functional impairment in family, peer, and/or school/daycare domains:
`` Inattention
`` Hyperactivity
`` Impulsivity
>> If positive response, schedule evaluation of the patient for ADHD
Evalu
>> Perform detailed interview with parents/caregiver concerning each of the 18 ADHD symp
`` Presence and duration, severity, and frequency
`` Age of onset
`` Circumstances of occurrences
`` Settings in which functional impairment occurs (as distinguished from presence of
>> Review with parents/caregiver symptoms of other common childhood psychiatric disorde
tic disorders, psychosis, substance abuse)
>> Have parents/caregiver complete a standardized behavior rating scale (Table 2); if possible, ob
>> Assess family history, structure, functioning, social interaction
>> Review patient���s perinatal, medical, mental health histories, developmental milestones
>> Interview patient to identify signs/symptoms inconsistent with ADHD or suggestive of ot
and content of thought
>> If patient���s medical history is unremarkable, laboratory tests or neurological studies are not
>> Psychological and neuropsychological testing are not mandatory for diagnosis of ADHD,
mathematics relative to intellectual ability
>> Patient meets DSM-IV-TR criteria for ADHD
Integrate data from Evaluation for presence of com
>> Symptoms meet full DSM criteria for separate comorbid disorder(s) in addition to ADHD
`` Oppositional defiant disorder or conduct disorder (usually present concurrently in
`` Major depressive disorder or specific anxiety disorder (usually occurs several years a
`` Mania (severe mood lability/elation/irritability, thought disturbances, severe aggres
>> Comorbid disorder is the primary disorder and patient���s ADHD symptoms are directly ca
>> Symptoms do not meet DSM criteria for separate comorbid disorder(s) but are secondary
Select treatment regimen
>> Choice of treatment regimen, especially pharmacologic intervention, is often influenced b
*Patient refers to any minor (preschooler, 3���5 yr; child, 6���12 yr; adolescent, 13���17 yr).
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