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Diagnosis and Treatment of ADHD in Adults in Primary Care

Brendan Montano, MD

Published: March 1, 2004

Article Abstract

The prevalence rate of adult attention-deficit/hyperactivity disorder (ADHD) indicates that 4.5%of adults continue to exhibit ADHD from childhood. Most adult sufferers of ADHD have not beenproperly diagnosed or treated. The majority of adults with ADHD exhibit at least 1 comorbid psychiatricdisorder, such as major depressive disorder, anxiety disorder, personality disorder, substanceabuse disorder, or bipolar disorder. In many instances, such a disorder may offer the first clue to diagnosingan adult with ADHD. Comorbidities may, however, confound a proper ADHD diagnosis, so itis important to look for and establish an early (childhood) and persistent (lifelong) history of inattentionor hyperactivity. The use of available standardized ADHD rating scales and checklists will thenhelp the physician to differentiate between ADHD and other comorbid psychiatric disorders commonlyseen in primary care. At present, there is no universally accepted and efficient standardizedassessment tool for identifying adult ADHD in primary care. However, the Adult Self-Report ScaleScreener may represent such a tool and may be used with ease in a busy office setting. Using suchstrategies, primary care providers are still able and encouraged to identify and treat adults withADHD.

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