Text adapted from: "The adult patient with attention-deficit/ hyperactivity disorder," in Psychiatry in primary care  by Umesh Jain (CAMH, 2019).

Steps to consider if you suspect ADHD

1. Apply the DSM-5 criteria to determine whether the patient has symptoms of ADHD. DSM-5 has decreased the number of required symptoms from six to five (the older DSM-IV version required six symptoms).
2. Use the assessment form from the eToolkit that accompanies the Canadian ADHD Practice Guidelines (login required) to help take a history and guide management. The form can be downloaded directly and put into the medical record. 
3. Use the Weiss Functional Impairment Rating Scale–Self from the eToolkit that accompanies the Canadian ADHD Practice Guidelines to document the patient’s baseline level of impairment, and use it sequentially to determine whether treatment is moving the patient toward normal functioning. 
4. If a suspected learning disability is also in the differential diagnosis, consider a referral to a community psychologist. This is expensive but necessary when problems arise in areas such as organization (i.e., executive functioning deficits), reading comprehension (e.g., making mistakes in reading, particularly in work situations) and handwriting skills.
5. Begin psychoeducation. (Visit the Psychoeducation page for more information.)

What other disorders can appear with ADHD?

The natural course of ADHD is to change into secondary anxiety and depression by adolescence, but ADHD remains the primary diagnosis. The concurrence of a personality disorder is also high, and ADHD should be considered in patients with bipolar II disorder, concurrent addictions to catecholamine substances (e.g., cannabis and cocaine), and other impulsive and anxiety disorders. The actual diagnosis might just be ADHD, with these other disorders as common secondary consequences of ADHD.

In Adult ADHD

• The Primary Care Practitioner Role
• Screening & Assessment
• Diagnosis
• Treatment
  • Pharmacotherapy
  • Psychotherapy
• Resources & References