When do you recommend neuropsychological testing in adults being evaluated for ADHD?

We should consider “testing” only when our main tool of diagnosis, a thorough psychiatric interview, history, and physical (mental status exam), demands more data for a diagnosis. Demanding neuropsych testing would be akin to relying more on an MRI than on a clinical assessment for a headache diagno...

Neuropsych testing is not necessary to diagnose ADHD. Even with neuropsych testing, results must be considered in the context of clinical evaluation. A comprehensive psychiatric evaluation is still the most reliable way to diagnose ADHD. I generally teach my residents to ask 3 questions:

1.) Do the ...

In theory versus in practice:

If resources and access weren’t barriers, I would say that every adult who doesn’t already have a well-documented ADHD diagnosis should ideally undergo full neuropsychological testing. A comprehensive evaluation not only clarifies ADHD but also helps rule out or identif...

With children in school (pre-college), often the schools or counties will have resources to get formal neuropsychological testing to evaluate for ADHD. It becomes harder as people transition into young adult (college age plus). My general rule of thumb is:

1.) If the patient is in college and has ne...

Many people misconstrue symptoms of bipolarity as ADHD, and they would probably prefer to carry that diagnosis anyway. And especially impatience with bipolar disorder, who also have a history of substance use disorder, they are often very eager to receive a psychostimulant. Of course, both could coe...

Though it would be nice to get neuropathy testing on all patients where there is an overlap in symptoms between sash’s and molar mania, as they share several symptoms. The more extreme the symptoms, the more emotion-laden they are. I think first of bipolarity, especially if there is a family history...

I mostly see adults in general outpatient psychiatry and in substance‑use rehab settings. I, too, believe that a thorough clinical history, especially looking for symptoms that go back to childhood, is crucial. When that part of the history is fuzzy, I’ll use the BAARS‑IV because it brings in collat...

I agree with other comments in that the clinical evaluation, history, and collateral information are critical in making this diagnosis.

If there is a question, however, or 1 suspects a differential, then I go to neuropsych testing.

Fascinating discussion interfacing the different skills and disciplines in mental health treatment.