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Challenges in diagnosing adults with ADHD.

Russell A Barkley1

  • 1Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, USA.

The Journal of Clinical Psychiatry
|February 11, 2009
PubMed
Summary

Diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) in adults are lacking in the DSM-IV-TR. Clinicians need to modify current criteria for accurate adult ADHD diagnosis until revised guidelines are available.

Area of Science:

  • Psychiatry
  • Neurodevelopmental Disorders

Background:

  • The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for ADHD were primarily designed for pediatric populations.
  • This has led to challenges in accurately diagnosing ADHD in adult patients.

Purpose of the Study:

  • To evaluate the limitations of the current DSM-IV-TR diagnostic criteria for adult attention-deficit/hyperactivity disorder (ADHD).
  • To suggest interim modifications for clinical practice.

Main Methods:

  • Analysis of existing DSM-IV-TR diagnostic criteria for ADHD.
  • Identification of specific problem areas concerning adult diagnosis.

Main Results:

  • Key issues identified include symptom descriptions, diagnostic thresholds, gender bias, and age at onset.

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  • Current criteria demonstrate limited suitability for diagnosing ADHD in adults.

    • Conclusions:

    • The DSM-IV-TR criteria require adaptation for effective adult ADHD diagnosis.
    • Modified application of current criteria is recommended pending the release of revised DSM-V guidelines.