(If you know about diagnosing ADHD and the DSM, you might skip down to the good bonus links.)
To Diagnose ADHD:
- Sometimes I can talk to and observe a patient for just a few minutes and it’s obvious that they have ADHD. But not usually. In any event, patients need a real evaluation to discover or to confirm the diagnosis.
- A real evaluation would take at least an hour. It need to be done by someone who understands ADHD – usually a psychiatrist, psychologist, or ADHD coach. Other conditions that can mimic ADHD need to be ruled out. Many professionals don’t understand that they don’t understand ADHD.
- The evaluation should include an interview with questions about childhood and current symptoms, probably a pencil and paper test (which could be done before the appointment, or after), and ideally, talking with at least one other person who knows the patient. Records from childhood, report cards etc. are helpful.
- Then the diagnosis and options can be discussed.
DSM-V and ADHD:
Actually, this is what I meant this post to be about. But I needed to address evaluation first. I’ll start now and finish this the next post (or two).
The Diagnostic and Statistical Manual, fifth edition, is published by the American Psychiatric Association. It is the universal bible of how to officially make a psychiatric diagnosis. It originally (DSM I) was intended for researchers so that scientists in different places could be sure that when they studied one type of patient, schizophrenia, for example, they were all diagnosing the same way. Then all the patients would be comparable. It also had some clinical usefulness, for example, you were struggling to figure out what kind of problem a patient had.
The insurance companies soon got hold of it (as well as the lawyers) and wouldn’t pay unless the official code number for a diagnosis was given. It has been misused and abused since.
It is far from perfect. It’s produced by committees amidst a lot of controversy, politics and turf issues. And there is just too much we don’t know about psychiatric problems. But it’s been tested for some scientific validity and it’s the best thing we have for now.
So it is useful for diagnosing someone with ADHD, for example, using the DSM criteria instead of just saying, “Well, he looks like it.”
Too much already. Next time.