There are three distinctive groups of referrals:
It is vital to obtain collateral information from other sources. Ideally this will be a relative who has known the patient for a long time and can provide information about symptoms present during childhood (a fundamental feature of A-ADHD). A parent would be the best source but obviously this is not always possible for adult patients.
ADHD symptoms are dimensional not categorical and they need to put into context, e.g. fidgeting in a boring lecture maybe normal, everybody has lost something, mood swings are part of a normal human experience. Always enquire (and document in detail) how severe and how often the symptoms are troubling the patient or people around them, request specific examples.
Three essential criteria must be satisfied for diagnosis (taken from DSM IV, please see appendix 1 for further advice):
Advice regarding to co-morbid conditions:
All the above is advice rather than absolute truths. Some patients’ presentations will not fit easily in any description so caution must be taken in order to avoid over and under-diagnoses.