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    Adhd19 Algorithm

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    Zayana4
    The document outlines the suggested approach for assessing and diagnosing adult ADHD which typically requires 2-3 visits. The first visit involves screening for symptoms and impairment, gathering history, and scheduling a second visit. The second visit involves interviewing the patient and an informant to corroborate childhood and current symptoms before determining if the DSM-5 criteria are met. The third visit involves explaining the diagnosis, discussing treatment options, and initiating treatment if recommended.

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    Adhd19 Algorithm

    Uploaded by

    Zayana4
    93 views1 page
    The document outlines the suggested approach for assessing and diagnosing adult ADHD which typically requires 2-3 visits. The first visit involves screening for symptoms and impairment, gathering history, and scheduling a second visit. The second visit involves interviewing the patient and an informant to corroborate childhood and current symptoms before determining if the DSM-5 criteria are met. The third visit involves explaining the diagnosis, discussing treatment options, and initiating treatment if recommended.

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    adhd19-algorithm

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    The document outlines the suggested approach for assessing and diagnosing adult ADHD which typically requires 2-3 visits. The first visit involves screening for symptoms and impairment, gathering history, and scheduling a second visit. The second visit involves interviewing the patient and an informant to corroborate childhood and current symptoms before determining if the DSM-5 criteria are met. The third visit involves explaining the diagnosis, discussing treatment options, and initiating treatment if recommended.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    93 views1 page

    Adhd19 Algorithm

    Uploaded by

    Zayana4
    The document outlines the suggested approach for assessing and diagnosing adult ADHD which typically requires 2-3 visits. The first visit involves screening for symptoms and impairment, gathering history, and scheduling a second visit. The second visit involves interviewing the patient and an informant to corroborate childhood and current symptoms before determining if the DSM-5 criteria are met. The third visit involves explaining the diagnosis, discussing treatment options, and initiating treatment if recommended.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Adult ADHD Assessment and Diagnosis Approach

    It is suggested that the diagnosis of adult ADHD requires 2-3 visits.


    Assessment of ADHD is not a clinical emergency and requires enough time
    to gather necessary evidence for the diagnosis.
    Suspect ADHD
    Self-referral
    Adult patient referred for assessment of potential ADHD
    Re-assessment of adult patient previously diagnosed with ADHD in childhood

    First Visit
    • Standard mental health assessment
    • Review current symptoms*
    • Assess current symptom using a brief validated tool*
    • Assess functional impairment at home, work, school and in relation-
    ships*
    • Identify comorbidities*
    • Perform screening for substance use*
    • Exclude other disorders
    • Assess physical health Consider Referral*: Consider referral to a psychiatrist
    • Gather/review additional information in the following several presentations and co-
    • Request past medical records and complete medical history
    conditions:
    • Request childhood and developmental history*
    • Identify informants and obtain consent to contact them to collect • Extreme or severe dysfunction
    information*
    • Schedule a second visit, preferably include an informant who can • Suicidal or homicidal ideations
    corroborate symptoms • Substance use or dependence
    • Psychosis
    • Extreme psychosocial stressors or present trau-
    matic events
    Second Visit (in 2-4 weeks) • Previous treatment failures
    • Review gathered information and assessment results
    • Atypical presentation – if presentation as brand
    new symptoms this is not ADHD, even if not diag-
    • Interview for corroboration of childhood symptoms nosed as a child the symptoms must concur
    • Interview for corroboration of current symptoms and disfunction
    • Consider severity of impairment
    • Meets DSM-5 criteria for ADHD diagnosis*
    • Confirm and document diagnosis

    Third Visit
    • Explain diagnosis*
    • Discuss treatment options, risks and benefits*; shared decision-making
    • Consider non-pharmacological management*
    • Initiate treatment if recommended*
    • Discuss need for treatment monitoring
    • Educate patient on their responsibilities in managing their condition
    and self-management strategies

    Follow-up Visits
    • New diagnosis, uncontrolled symptoms or change in medication – within 30 days; monthly until functionality is significantly improved;
    every 3-6 months once stabilized
    • Review symptoms and functional abilities, including diurnal variations in symptoms
    • Review impressions of informants
    • Monitor for drug adverse effects*
    • Monitor for adherence to therapy
    • Monitor vital signs (weight, blood pressure and heart rate)
    • Monitor for signs of misuse/abuse/diversion
    • Adjust therapy as needed
    • Assist with additional management strategies for psychological, behavioral, occupation and educational needs (e.g., skill-building
    trainings, psycho-education, parenting, vocational and/or educational accommodation)*

    * = Resource available in this Toolkit; this approach is suggested as a general guidance only and is modifiable to fit local context;
    second and third visits can be combined if enough evidence to diagnose ADHD and initiate treatment
    Copyright © 2019 American Academy of Family Physicians. All rights reserved
    Authors: Loskutova N, Callen E, Lutgen C; 2019, AAFP National Research Network
    Updated August 30, 2019

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