Commentary on Sources of Attention-Deficit/Hyperactivity Overdiagnosis Among U.S. Adults.

Abstract

Diagnosis of adult attention-deficit/hyperactivity disorder (ADHD) has risen precipitously in recent years in the United States. This has been accompanied by a corresponding increase in rates of stimulant medication prescriptions, resulting in prescription drug shortages. These data raise concern that adult ADHD may be overdiagnosed. This article examines factors that can contribute to adult ADHD overdiagnosis. Sources of overdiagnosis include lack of adherence to DSM-5-TR diagnostic criteria, poor diagnostic practices, malingering, electronic distractions, cultural shifts in how the term "ADHD" has been used, and other health conditions that impair attention. More rigorous diagnostic practices are necessary to ensure appropriate diagnoses and treatments are offered. Adopting such practices will help optimize patient outcomes. Such practices include ruling out other conditions that impair attention, taking a careful developmental history, gathering information from collateral sources, and evaluating the patient for functional impairments.