Tests and diagnosis

By Mayo Clinic Staff

Different types of doctors may diagnose and supervise treatment for ADHD. Seek a provider who has training and experience in caring for adults with ADHD. Psychiatrists, psychologists, family doctors and neurologists may diagnose ADHD, but only psychiatrists and psychologists are likely to provide counseling. Psychologists do not prescribe medication.

Diagnosing ADHD in adults

It can be more challenging to identify ADHD in adults than in children. Signs and symptoms in adults can be hard to spot. No single test can confirm the diagnosis. Your doctor will likely start by doing a physical exam and asking you questions.

Ruling out other conditions

Your doctor or mental health provider will consider whether your symptoms may be caused by something other than ADHD. Conditions that can cause symptoms similar to those caused by ADHD include:

  • Mental health disorders. Several mental health conditions can mimic ADHD both in children and in adults, including anxiety disorders, mood disorders, adjustment disorders, learning and language deficits, and psychotic disorders.
  • Other health problems. Your doctor may consider a different diagnosis or refer you to a specialist if you have a history of other conditions, such as a developmental disorder, seizures, a thyroid disorder, lead poisoning or low blood sugar (hypoglycemia).
  • Drugs and medications. Alcohol or drug abuse and certain medications can cause ADHD-like symptoms.

Evaluating signs and symptoms from childhood

A persistent pattern of signs and symptoms as a child is essential for a diagnosis of adult ADHD. You may have a hard time remembering whether your problems date back to childhood. For that reason, your doctor may ask for your old school records and for information from teachers, parents and anyone else who knew you when you were young. Your doctor may also ask to hear from your spouse, a parent, close friend or someone else who knows you well.

Diagnostic criteria for ADHD

To be diagnosed with ADHD, you must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. You must have six or more signs and symptoms from one or both of the two categories below.

Inattention

  • Often fails to give close attention to details or makes careless mistakes in work or other activities
  • Often has difficulty sustaining attention in tasks
  • Often doesn't seem to listen when spoken to directly
  • Often doesn't follow through on instructions and fails to finish tasks
  • Often has difficulty organizing tasks and activities
  • Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
  • Often loses items necessary for tasks or activities
  • Is often easily distracted
  • Is often forgetful in daily activities

Hyperactivity and impulsivity

  • Often fidgets with hands or feet or squirms in seat
  • Often leaves the room when remaining seated is expected
  • Often is physically active or restless in situations when it's inappropriate
  • Often has difficulty quietly engaging in leisure activities
  • Is often "on the go" or often acts as if "driven by a motor"
  • Often talks too much
  • Often blurts out answers before questions are completed
  • Often has difficulty awaiting turn
  • Often interrupts or intrudes on others' conversations

In addition to having at least six symptoms from these categories, someone with adult ADHD:

  • Has inattentive or hyperactive-impulsive signs and symptoms that caused impairment and were present as a child
  • Had behaviors that weren't normal for children the same age who didn't have ADHD
  • Has symptoms for at least six months
  • Has symptoms in more than one setting that significantly impair performance at school or work or negatively impact home life or relationships

Other criteria

Because symptoms of ADHD may differ in adults from those in the DSM criteria — especially those listed for symptoms of hyperactive behavior — other criteria more specific to adults are generally used to help confirm a diagnosis.

Your doctor may give you a questionnaire and expanded list of signs and symptoms to help determine whether you have ADHD. In addition, your doctor will carefully examine the impact of your symptoms on your current life — your performance at work or in school and your relationships with friends and family.

Mar. 07, 2013