A Practical Guide for Diagnosing Adult ADHD
Spencer and Alder recommend that the PCP use a clinician-administered assessment or interview with each new patient to make the diagnosis of ADHD. The interview format requires more PCP time to complete than simply reviewing independently completed rating scales. However, this interview supports the clinician in investigating symptoms in a semi-structured format, thus allowing the patient to recognize his or her personal ADHD symptoms. The interview format enables the PCP to collect retrospective and current data (eg, academic records, test histories, performance reviews, speeding tickets, and grade point average) that can be used to establish functional impairment in adults.
The interview format also facilitates assessment of 3 of the DSM-IV-TR diagnostic criteria of ADHD: childhood onset, functional impairment in 2 or more settings, and no mental illness diagnosis that explains the impairment. Several interview-based assessment instruments are available, such as Conner's Adult ADHD Diagnostic Interview for DSM-IV (CAADID), Adult Interview by Barkley and Murphy, and Brown ADD Scale Diagnostic form (Brown ADD-DF). Although any instrument can be used in an interview format, for the new or inexperienced provider, using an instrument designed for interviewing can facilitate the interaction and ease of diagnosis.
Clinician-administered Assessment/Interview
Spencer and Alder recommend that the PCP use a clinician-administered assessment or interview with each new patient to make the diagnosis of ADHD. The interview format requires more PCP time to complete than simply reviewing independently completed rating scales. However, this interview supports the clinician in investigating symptoms in a semi-structured format, thus allowing the patient to recognize his or her personal ADHD symptoms. The interview format enables the PCP to collect retrospective and current data (eg, academic records, test histories, performance reviews, speeding tickets, and grade point average) that can be used to establish functional impairment in adults.
The interview format also facilitates assessment of 3 of the DSM-IV-TR diagnostic criteria of ADHD: childhood onset, functional impairment in 2 or more settings, and no mental illness diagnosis that explains the impairment. Several interview-based assessment instruments are available, such as Conner's Adult ADHD Diagnostic Interview for DSM-IV (CAADID), Adult Interview by Barkley and Murphy, and Brown ADD Scale Diagnostic form (Brown ADD-DF). Although any instrument can be used in an interview format, for the new or inexperienced provider, using an instrument designed for interviewing can facilitate the interaction and ease of diagnosis.
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