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Attention-deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental disorders among children, although it also occurs in adults.

The official definitions of ADHD according to the US Surgeon General and ICD-9-CM (International Classification of Disease Revised Edition 2005) is a neurological deficit classified as "metabolic encephalopathy" affecting the release and homeostasis of neurological chemicals and the functioning of the limbic system.

The official definition of ADHD found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-IV (Text Revision) (DSM-IV-TR), defines three subtypes of ADHD:

  • Predominantly Inattentive,
  • Predominantly Hyperactive-Impulsive, and
  • Combined Type.

Although most diagnoses of ADHD are made for children, the DSM definitions of ADHD do not confine the disorder solely to childhood and in fact many adults are also diagnosed. Current theory holds that approximately 30% of children diagnosed retain the disorder as adults. Although the disorder may not have been diagnosed in an individual during childhood, it is also currently thought that all adults with Adult attention-deficit disorder (AADD) had it in childhood. Hyperactivity and other symptoms may be less noticeable in adults with ADD/ADHD who have learned better coping skills and other forms of adaptive behavior than they had as children. Particularly in adults, studies have shown a high correlation between ADHD and creativity. Many painters and performing artists seem to show significant evidence of ADHD, particularly those drawn to improvisational humor and stand up comedy (see Robin Williams, the poster child for adult ADHD).

ADHD Symptoms

In children ADHD symptoms are characterized by:

  • inattentiveness to external direction
  • impulsive behavior
  • restlessness.

However, children with ADHD symptoms of the inattentive type are actually often:

  • sluggish
  • hypo-active

A diagnosis of ADHD is made based on a checklist of symptoms that can be found in DSM-IV-TR. A hyperlink to the Centers for Disease Control and Prevention (CDC) web page summarizing these criteria is given in the External links section below.

The CDC emphasizes that a diagnosis of ADHD should only be made by trained health care providers. This is important as many of the criteria can be readily misinterpreted and the prescribed drugs can be very dangerous.

Psychological testing for ADHD

Psychological testing for ADHD symptoms generally consists of obtaining multiple types of assessments. These usually include a clinical interview reviewing the DSM-IV criteria for ADHD diagnosis. The interview also needs to rule out as much as possible other types of syndromes which can cause attention problems, such as depression, anxiety, allergies and psychosis. Rating scales can be administered which provide measurement of the person's own view of their symptoms, as well as the views of parents, teachers, and significant others.

Finally, computerized tests of attention can be helpful in providing a further independent assessment. These different assessments may not be consistent, but do provide a view of the person's difficulties. Subjectivity of the analysis can be compounded by the fact that physicians generally need not order psychological testing in order to make the diagnosis of ADHD, but many doctors use this kind of assessment to avoid over-diagnosis and treatment. The process of obtaining referrals for such assessments is being promoted vigorously by the President's New Freedom Commission on Mental Health

Posted by Staff at May 23, 2005 8:03 PM

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