Diagnosing ADHD in adults in randomized controlled studies: a scoping review

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Adult attention-deficit/hyperactivity disorder (ADHD) diagnosis is increasing.
• Diagnostic criteria for adult ADHD have evolved from childhood definitions, leading to increased subjectivity.
• There is a need to clarify best practices for diagnosing adult ADHD in research settings.

Purpose of the Study:

• To examine current diagnostic methodologies for adult ADHD in research.
• To identify variations and inconsistencies in how adult ADHD is diagnosed in randomized controlled trials (RCTs).

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted.
• The review focused on the diagnostic procedures employed in studies involving adult ADHD.

Main Results:

• A substantial variation in diagnostic methods was observed across 292 RCTs, with no clear consensus.
• Over half of the studies lacked assessment of general psychopathology, and only 35% involved psychiatrists or psychologists in diagnosis.
• Comorbid psychiatric conditions were present in more than half of the included studies.

Conclusions:

• Concerns exist regarding the diagnostic validity of adult ADHD in numerous RCTs.
• Prioritizing accurate diagnostic assessment is crucial for the clinical relevance of research findings.
• Improving diagnostic quality, including comprehensive differential diagnosis by specialists, is essential for advancing adult ADHD research.