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Difficult diagnosis – the dilemma of reliable evaluation of ADHD in adult patients. Part II. Process of diagnosis and differential diagnosis

Monika Szaniawska

Affiliacja i adres do korespondencji
PSYCHIATR. PSYCHOL. KLIN. 2010, 10 (3), p. 211-217
Streszczenie

There is no doubt that the diagnosis of ADHD in adult patients is a difficult process and should be made by a versatile and reliable clinician. In evaluation the clinician should consider various aspects from the patient’s history, assess her/his present functioning, extent of the functioning deficiency in adult life, and exclude all other alternatives which could account for attention deficits, hyperactivity and impulsivity. In an adult person, ADHD may be diagnosed in a patient who has suffered from this disorder from childhood. It is hardly probable that the person who presently meets the diagnostic criteria of ADHD but had not experienced a deterioration in functioning by graduation from high school will be diagnosed with this disorder. When diagnosing ADHD in adults we have to find evidence of poor or inadequate adaptation which may result in: loss of a job, long-lasting difficulties with finishing the higher studies, academic achievements far below intellectual capabilities, difficulties in marriage or in maintaining close relations with other people. A very important activity, unfortunately often passed over, in ADHD diagnosis in adults, is systematic checking whether or not the occurring difficulties are actually induced by other mental disorders or somatic diseases. It should be checked whether or not the patient’s symptoms occur in the course of bipolar affective disorder, substance use disorder or personality disorders, especially the borderline personality. The last important step in the diagnostic process is finding out if there are no other disorders, apart from ADHD. Noteworthily, many disorders which should be considered in the differential diagnosis may occur not instead of ADHD, but concurrently.

Słowa kluczowe
ADHD in adults, ADHD diagnosis in adults, differential diagnosis, comorbidity, diagnostic procedure