Attention-deficit hyperactivity disorder psychiatric examination

Jump to navigation Jump to search

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2], Haleigh Williams, B.S.

Attention-deficit hyperactivity disorder Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Attention-Deficit Hyperactivity Disorder from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Psychiatric Examination

Laboratory Findings

Imaging Findings

Treatment

Medical Therapy

Psychotherapy

Brain Stimulation Therapy

Cost-Effectiveness of Therapy

Monitoring Response to Therapy

Future or Investigational Therapies

Case Studies

Case #1

Template:Attention-deficit hyperactivity disorder On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Attention-deficit hyperactivity disorder psychiatric examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Attention-deficit hyperactivity disorder psychiatric examination

CDC on Attention-deficit hyperactivity disorder psychiatric examination

Attention-deficit hyperactivity disorder psychiatric examination in the news

Blogs on Attention-deficit hyperactivity disorder psychiatric examination

Directions to Hospitals Treating Attention-deficit hyperactivity disorder

Risk calculators and risk factors for Attention-deficit hyperactivity disorder psychiatric examination

Overview

A complete psychiatric examination should be performed by a psychiatrist, with additional information provided by teachers, if applicable. Psychiatric examination should focus on the DSM V criteria for ADHD, as well as on symptoms that would differentiate ADHD from other psychiatric diagnoses.

Psychiatric Examination

  • Many of the symptoms of ADHD occur from time to time in everyone. In those with ADHD, these symptoms occur frequently and impairs regular life functioning, typically at school or at work. ADHD patients often perform poorly in task-oriented settings, as well as experiencing difficulty with social functioning. No objective physical test exists for the diagnosis of ADHD. As with many other psychiatric and medical disorders, the formal diagnosis is made by a qualified professional in the field based on a set number of criteria. In the United States, these criteria are set forth by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th edition.

Additional Diagnostic Information

In the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) the symptoms of ADD are given the name "Hyperkinetic disorders." When a conduct disorder (as defined by ICD-10[1]) is present, the condition is referred to as "Hyperkinetic conduct disorder." Otherwise, the disorder is classified as "Disturbance of Activity and Attention," "Other Hyperkinetic Disorders," or "Hyperkinetic Disorders, Unspecified." The latter is sometimes referred to as "Hyperkinetic Syndrome."[1]

The American Academy of Pediatrics Clinical Practice Guidelines for children with ADHD emphasize that a reliable diagnosis is dependent upon the fulfillment of three criteria:[2]

  • The use of explicit criteria for the diagnosis using the DSM V
  • The attainment of information about the patient's symptoms in more than one setting
  • The search for coexisting conditions that may make the diagnosis more difficult or complicate treatment planning

The first criterion can be satisfied by using an ADHD-specific instrument such as the Conners' Rating Scale.[3] The second criterion is best fulfilled by examining the individual's history, which can be obtained from parents, teachers, or a patient's memory.[4] The requirement that symptoms be present in more than one setting is very important because the problems a child experiences may be situational, and thus not indicative of a disorder. The use of intelligence testing, psychological testing, and neuropsychological testing to satisfy the third criterion is essential in order to find or rule out other factors that might be causing or complicating the problems experienced by the patient.[5]

The Centers for Disease Control and Prevention (CDC) state that a diagnosis of ADD should only be made by trained health care providers, as many of the symptoms may also be part of other conditions. It is not uncommon that physically and mentally non-pathological individuals exhibit at least some of the symptoms from time to time. Severity and pervasiveness of the symptoms leading to prominent functional impairment across different settings (school, work, social relationships) are major factors in a positive diagnosis.

References

  1. 1.0 1.1 ICD Version 2006: F91. World Health Organization. Retrieved on December 11, 2006.
  2. Perrin JM, Stein MT, Amler RW, Blondius TA. 2001. "Clinical practice guideline: treatment of school-aged children with Attention Deficit/Hyperactivity Disorder". Pediatrics 108 (4):1033-1044. PMID 11581465
  3. Conners CK, Sitarenios G, Parker JD, Epstein JN (1998). "Revision and restandardization of the Conners Teacher Rating Scale (CTRS-R): factor structure, reliability, and criterion validity". Journal of abnormal child psychology. 26 (4): 279–91. PMID 9700520.
  4. Ratey, John; Hallowell, Edward. Driven to Distraction first edition, p. 42
  5. Ninivaggi, F. J. "Borderline intellectual functioning and academic problem." In: Sadock B.J. Sadock, V.A., eds. Kaplan & Sadock's Comprehensive Textbook of psychiatry. 8th ed. Vol. II. Baltimore: Lippincott William and Wilkins; 2005: 2272–76.

Template:WH Template:WS