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Is Adult Attention-Deficit Hyperactivity Disorder Being Overdiagnosed?
Joel Paris1, Venkat Bhat2, Brett Thombs3
1Research Associate, Institute of Community and Family Psychiatry, Sir Mortimer B Davis Jewish General Hospital, Montreal, Quebec; Professor, Department of Psychiatry, McGill University, Montreal, Quebec.
Abstract:
This review offers a perspective on the question as to whether attention-deficit hyperactivity disorder (ADHD) is being overdiagnosed in adults. Considering underlying causes as well as consequences, we conclude that the diagnosis of adult ADHD should be made cautiously, making use of multiple sources of information, including self-report, clinical interviews, collateral information, childhood documentation, and neuropsychological testing. Routine screening with symptom checklists is insufficient, and stimulant response is diagnostically uninformative. The causes of overdiagnosis may include changes in diagnostic thresholds, poor diagnostic practices, and advertising by the pharmaceutical industry. Overdiagnosis leads to overtreatment, and dramatic increases in prescriptions for adult ADHD during the last decade should arouse concern.
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