How many suspected adult ADHD cases actually receive the diagnosis? Related factors in an assessment-seeking sample.

IF 4.6 3区 医学 Q2 CLINICAL NEUROLOGY
Gianluca Rosso, Camilla Perotti, Beatrice Defilippi, Camilla Garrone, Giuseppe Maina, Gabriele Di Salvo
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Abstract

Objective: Adult ADHD assessments have increased sharply in recent years, yet the diagnostic yield and predictors of confirmed ADHD among assessment-seeking individuals remain insufficiently understood. This study aimed to examine the sociodemographic and clinical characteristics of adults self-referred or referred by clinicians for suspected ADHD, to determine confirmation rates, factors associated with confirmation, and alternative diagnoses.

Methods: A cross-sectional study was conducted on 232 adults evaluated at a regional ADHD referral center. Assessments included semi-structured clinical interviews and standardized instruments (DIVA, SCID-5, ADHD-RS). Logistic regression was used to examine factors associated with the final clinical ADHD diagnosis.

Results: Overall, 64.2% of individuals received an ADHD diagnosis. Compared with non-ADHD participants, those diagnosed with ADHD were more frequently referred by other healthcare professionals and displayed greater academic impairment. They also showed higher rates of mood swings and delayed sleep onset. Childhood inattention emerged as the only DIVA interview score significantly associated with an ADHD diagnosis. Among individuals without ADHD, the most frequent alternative diagnoses were anxiety disorders and depressive disorders, followed by personality disorders, substance use disorders, and bipolar disorders.

Conclusions: Adult ADHD emerges as a multifactorial condition shaped by clinical and functional factors. The final clinical diagnosis was most strongly associated with structured clinical tools, functional impairments (in the academic domain), emotional-regulation difficulties, and childhood inattention, whereas self-reported and more general factors were less informative. These findings underscore the importance of a developmentally informed and comprehensive assessment approach, given the high prevalence of psychiatric conditions that may mimic ADHD.

有多少成人ADHD疑似病例得到了诊断?寻求评估样本中的相关因素。
目的:近年来,成人ADHD评估急剧增加,但在寻求评估的个体中确诊ADHD的诊断率和预测因素仍然缺乏充分的了解。本研究旨在检查自我推荐或由临床医生推荐的成人疑似ADHD的社会人口学和临床特征,以确定确认率、与确认率相关的因素和替代诊断。方法:对某地区ADHD转诊中心的232名成人进行横断面研究。评估包括半结构化临床访谈和标准化工具(DIVA, SCID-5, ADHD-RS)。使用Logistic回归来检查与最终临床ADHD诊断相关的因素。结果:总体而言,64.2%的个体被诊断为ADHD。与非ADHD参与者相比,那些被诊断为ADHD的参与者更经常被其他医疗保健专业人员转诊,并且表现出更大的学业障碍。他们还表现出更高的情绪波动率和睡眠延迟。儿童注意力不集中是唯一与ADHD诊断显著相关的DIVA访谈得分。在没有多动症的个体中,最常见的替代诊断是焦虑症和抑郁症,其次是人格障碍、物质使用障碍和双相情感障碍。结论:成人ADHD是一种由临床和功能因素共同影响的多因素疾病。最终的临床诊断与结构化临床工具、功能障碍(在学术领域)、情绪调节困难和儿童注意力不集中密切相关,而自我报告和更一般的因素信息较少。这些发现强调了发展信息和综合评估方法的重要性,考虑到可能模仿ADHD的精神疾病的高患病率。
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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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