Diagnosing Late-Onset ADHD May Require Ruling Out Substance Use, Other Disorders

Although some patients who screen positive for attention-deficit/hyperactivity disorder (ADHD) in adolescence or adulthood may represent valid late-onset cases, astudy inAJP in Advance suggests there may be other explanations for the emergence of ADHD symptoms later in life.After using a multistep assessment that took into consideration psychiatric symptoms, impairment, and substance use patterns from childhood to adulthood, Margaret Sibley, Ph.D., of Florida International University in Miami and colleagues concluded approximately 95% of the patients who initially screened positive on symptom checklists should not be diagnosed with late-onset ADHD. “Among individuals with impairing late-onset ADHD symptoms, the most common reason for diagnostic exclusion was symptoms or impairment occurring exclusively in the context of heavy substance use,” Sibley and colleagues wrote. “Prior to diagnosing or treating ADHD in late-onset cases, clinician s should carefully assess and treat substance use and comorbid mental health disorders as a potential source of symptoms.”Sibley and colleagues analyzed data on 239 individuals who were not diagnosed with ADHD as children but participated in theMultimodal Treatment Study of ADHD as part of the trial ’s comparison group (a sample drawn from the same local school, sex, and age/grade pool as the ADHD sample in the study). Participants in the comparison group received regular assessments over a 14-year period, including parent, tea...
Source: Psychiatr News - Category: Psychiatry Tags: ADHD ajp in advance Margaret Sibley Multimodal Treatment Study of ADHD substance use disorder Source Type: research