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When adults are tested for ADHD, does a doctor screen for other problems?

John Preston, PsyD
Psychology

It is absolutely necessary to screen for a number of disorders when one is being evaluated for possible ADHD. Many psychological and neurological disorders have symptoms similar to ADHD. In adults these symptoms include: being very disorganized, difficulty staying on task, problems maintaining motivation to complete tasks (especially tasks that are boring or tedious), poor time management (this manifests itself in chronically being late for things or waiting to the last minute to meet deadlines: what is perceived as procrastination), excessive emotional sensitivity, and impulsivity (reacting without stopping to carefully think about certain decisions).

This cluster of symptoms can also be seen in the following: in people who have sustained various forms of brain damage (e.g. head injuries), certain personality disorders (e.g. borderline personality disorder), impulse control disorders, anxiety disorders such as severe generalized anxiety disorder, obsessive-compulsive disorder, and adjustment disorders (this can certainly include reactions to recent or on-going significant stressors; e.g. a person who is going through a very painful divorce; caring for a parent with Alzheimer's disease; losing a job and dealing with unemployment...here these very difficult situations are consuming to the person making it difficult to stay focused or function in ways that are more characteristic of who they are) and sometimes major psychiatric disorders such as bipolar disorder. There are medical conditions that can cause these symptoms such as endocrine disorders or neurological illnesses. And finally (a common cause) is substance abuse ranging from excessive caffeine use to alcoholism and abuse of cocaine or methamphetamine.

The diagnosis of ADHD should NEVER be made only based on symptoms. A comprehensive evaluation must include a detailed history, some basic medical screening, and (ideally) input from a significant other.

Douglas E. Severance, MD
Family Medicine
In many cases, more than one specific psychiatric disorder can coexist with attention deficit hyperactivity disorder (ADHD). That is why it is important for the diagnosing clinician to screen for other psychiatric disorders, such as learning disabilities, anxiety disorders, substance use disorders, or depression, when completing the series of evaluations for ADHD.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.