Diagnosis and Assessment of Disease
ADHD Diagnos Scree
> As part of a mental health assessment, regardless of presenting complaint, ask parents/ca > If positive response, schedule evaluation of the patient for ADHD
causing functional impairment in family, peer, and/or school/daycare domains: ` Inattention ` Hyperactivity ` Impulsivity
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). 2
