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ADHD, attention deficit hyperactivity disorder, is a developmental neuropsychiatric disorder that begins in childhood. Its main symptoms are problems with attention, hyperactivity and impulsiveness. If these symptoms are occasional, it’s normal, but in ADHD they are frequent, long-term and impair functional capacity. Symptoms may also include problems with executive function and trouble controlling emotions and behaviour.

ADHD does not begin in adolescence or adulthood, and the diagnosis of ADHD requires the disrupting symptoms to have started in early childhood. If the symptoms appear in adolescence or adulthood, they are likely to be caused by something else. The disorder occurs in about 2–4% of adults.

How is a developmental neuropsychiatric disorder diagnosed?

A developmental neuropsychiatric disorder can be diagnosed in adulthood only if there have been documented symptoms since primary school and these cause significant disruption in everyday life. That’s why the examinations include collecting childhood-related information from a parent or other carer as well as from the school, student welfare and health care records.

A wide-ranging examination is made of the person’s symptoms, life situation and functional capacity. Information collected includes:

  • functional capacity and the occurrence of symptoms in different situations
  • mental and physical health
  • the use of intoxicants
  • developmental background and
  • other symptom-related factors.

In differential diagnosis, other conditions and disorders must be considered as the possible cause of the symptoms. Concentration may be significantly impaired by problems such as traumas, epilepsy, learning difficulties, lack of sleep, sleep apnoea, depression, anxiety, bipolar disorder, psychotic disorder, borderline personality disorder or heavy use of intoxicants.

Many of these may occur alongside ADHD. Any other conditions should be treated before a developmental disorder can be examined reliably.

When should you be examined?

Diagnosing developmental neuropsychiatric disorders in adults is challenging. Features of these disorders occur in many people, but making a diagnosis requires confirmation of symptom clusters and diagnostic criteria.

Mild neuropsychiatric symptoms don’t necessarily require a diagnosis if functional capacity is good, if treatment is not needed or if self-care is sufficient.

If you suspect you may have developmental attention deficit hyperactivity disorder ADHD and the condition was not diagnosed in childhood, then it could be a good idea to talk with your parents before seeking treatment. They can tell you what kinds of symptoms you had in childhood. Together you can start collecting some of the preliminary information that will be required for an examination.

Useful sources of information include:

  • school reports, especially written assessments made during primary school, progress notes and school readiness assessments
  • student welfare reports, psychological evaluations, learning difficulty assessments
  • health records from the maternity clinic, school health care or other treatment centre (such as a family counselling centre or psychiatric care)

If you are already being examined elsewhere, it could be good to consider completing the examinations at your current treatment centre.

Try self-care tips first

Before booking an appointment for a neuropsychiatric examination, go through the list below and assess how well the following apply to you.

  • My daily rhythm is fairly regular. I study and work in moderation, ensure enough recovery time and sleep 7 to 8 hours a night.
  • I eat enough and at regular mealtimes. I eat breakfast, lunch, dinner and snacks.
  • Exercise is part of my lifestyle. Everyday exercise and a few heavy exercise sessions a week help me relax and manage stress.
  • I’ve reviewed my approach to studying: I avoid excessive stimuli, concentrate on one thing at a time and reserve time for studying without disruptions.
  • I don’t use drugs and I don’t drink much alcohol.
  • The time I spend on smart devices, the internet and games is moderate.

The symptoms of ADHD and ADT are similar

ADT (attention deficit trait) is a self-created concentration difficulty similar to impaired ability to concentrate in those with ADHD. ADT is not a neurobiological disorder or medical diagnosis, and anyone can detect this problem in themselves.

ADT is caused when the brain is used to “bouncing” between different stimuli over time and keeps doing it even when there’s no need to. In a way, the brain is constantly in a state of alarm. People with ADT keep distracting themselves.

ADT is becoming more and more common because of our lifestyle. Frequent use of smart devices impairs our ability to concentrate. The sounds of mobile phones, emails and social media keep distracting our work.

People can predispose themselves to ADT if

  • they don’t get sufficient rest
  • they are constantly trying to multitask
  • they jump from one thing to another and have to interrupt what they’re doing.

It’s not a permanent state and you can learn to avoid it. Improving your ability to concentrate is possible.

FSHS psychiatrist / 14 th Mars 2022