How do you approach effectively diagnosing ADHD within the time constraints of outpatient practice?  

I approach diagnosing ADHD by asking a series of questions. Questions 1 - 3 are pretty straightforward, the others can be more nuanced depending on the case: 1) Do enough ADHD symptoms apply (6 symptoms in 1 category for kids, 5 symptoms in adults)? I ask about specific symptoms and encourage the p...

I frame the initial diagnostic interview in the context that concentration issues are a symptom and not necessarily a diagnosis. Many DSM-5-TR diagnoses included loss of concentration, ranging from mood disorders to anxiety disorders to trauma-based conditions. If anything else is present, then I co...

It also helps to use longer-acting formulas on adults, as there is less chance of overdosing since it doesn’t give patients as much of a reinforcing “high“ feeling.

I think it's important to set the frame with patients that a thorough assessment for ADHD will not be possible in a single one-hour visit, and that they should expect the assessment to be a process that extends across several appointments. If there are confounding comorbid conditions that aren't so ...

I look for a childhood history of stimulants, assuming that a proper diagnostic workup was made at the time, to justify the use of medication in childhood. Sometimes adults in high-pressure work situations, especially when there is an open floor plan with many distractions, will develop ADHD. This i...