Diagnosis and treatment of ADHD in adults in primary care

The prevalence rate of adult attention-deficit/hyperactivity disorder (ADHD) indicates that 4.5% of adults continue to exhibit ADHD from childhood. Most adult sufferers of ADHD have not been properly diagnosed or treated. The majority of adults with ADHD exhibit at least 1 comorbid psychiatric disorder, such as major depressive disorder, anxiety disorder, personality disorder, substance abuse disorder, or bipolar disorder. In many instances, such a disorder may offer the first clue to diagnosing an adult with ADHD. Comorbidities may, however, confound a proper ADHD diagnosis, so it is important to look for and establish an early (childhood) and persistent (lifelong) history of inattention or hyperactivity. The use of available standardized ADHD rating scales and checklists will then help the physician to differentiate between ADHD and other comorbid psychiatric disorders commonly seen in primary care. At present, there is no universally accepted and efficient standardized assessment tool for identifying adult ADHD in primary care. However, the Adult Self-Report Scale Screener may represent such a tool and may be used with ease in a busy office setting. Using such strategies, primary care providers are still able and encouraged to identify and treat adults with ADHD.