Assessment and Diagnosis of Adult ADHD: Clinical Challenges and Opportunities for Improving Patient Care

Attention-deficit/hyperactivity disorder (ADHD) is commonly perceived as a childhood disorder, but it persists into adulthood in 35% to 70% of affected people. The symptoms, deficits, and consequences associated with ADHD have a profound negative impact on the lives of patients and their families. Barriers to diagnosing ADHD in adults include diagnostic criteria developed and field-tested in children, nonspecificity of symptoms, high incidence of comorbid disorders that could mask or distract from the ADHD diagnosis, variation in presenting symptoms by gender and ethnicity, and lack of definitive diagnostic tools. Given the relatively high prevalence of ADHD compared with other psychiatric disorders, clinicians should maintain a high index of suspicion and integrate screening for ADHD into all routine psychiatric evaluations. Accurate diagnosis requires a comprehensive clinical interview, including evaluation of past and present symptoms and longitudinal course and assessment of functional impairment. It is often necessary to interview or obtain information from family,