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No evidence ADHD is being over-diagnosed, say experts (www.cam.ac.uk)
submitted 7 months ago* (last edited 7 months ago) by to c/science@lemmy.world
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Research.

Overdiagnosis is not a problem, but misdiagnosis may be as people are driven into the private sector by long waits, and sadly, missed diagnoses remain common —Tamsin Ford

Experts are warning that far from being over-diagnosed, people with ADHD are waiting too long for assessment, support and treatment.

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[–] 22 points 7 months ago (13 children)

It's quite costly to run an fMRI. Not needed if you can get the same results more or less from a questionnaire.

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  • [–] 27 points 7 months ago (11 children)

    In my professional experience, it can be hard to tell between ADHD symptoms and CPTSD symptoms. The checklist is not a great way to diagnose people. We usually do a lot more assessments, I also use a computerized test to measure reaction time and error commission.

    I wish we (therapists) at least had the option to order an MRI or recommend a doctor orders one in difficult cases (I can do the latter but they will just laugh at me).

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  • [–] 8 points 7 months ago (4 children)

    Wait, is there an actual chance to "see" ADHD in an MRI image? I was under the impression that we can't do that (yet) and the only way to diagnose was through questionnaires, attention testing and such. That's what I was told by the doctor who ultimately diagnosed me two years ago

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  • [–] 9 points 7 months ago

    Wait, is there an actual chance to "see" ADHD in an MRI image?

    Only fMRI, which is different, and even more expensive. It's basically the same as asking you a bunch of questions but then seeing which parts light up. Brain can't lie.

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  • [–] 8 points 7 months ago* (2 children)

    Like @yucandu@lemmy.world said, it would need to be an fMRI, which is primarily used in research as far as I know. And while it alone could not tell you definitively "this person has ADHD," it could help rule out other conditions (like TBI, which can also present similar to ADHD). Ultimately, your doctor is right that a standard MRI cannot diagnose it.

    I like to combine the checklist with interviews (like DIVA, Diagnostic Interview for ADHD in Adults) and computerized continuous performance tests, like QBTest. Of course, there is also a lot of observation and sometimes even asking humorous questions, like "Do you have The Chair^TM^ at home?"

    The Chair^TM^

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  • [–] 4 points 7 months ago (1 child)

    Do you know if there any studies on whether the effects of the medicine used for ADHD could have similar positive effects on people with CPTSD?

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  • [–] 6 points 7 months ago

    Great question! To my knowledge, they are just starting to look into it, but with PTSD specifically, not CPTSD. There is this case study (n=1) and this pilot study (n=32) that show promise. They are recruiting people for more testing.

    Preliminary evidence shows that it does help - and it makes sense. If cognitive deficits from PTSD are a result of an impaired executive function, then stimulants would help with those particular symptoms, much like in ADHD.

    Here's the thing though - the US healthcare system still doesn't even have CPTSD as a diagnosis, so there is not too much research happening on the topic here. Considering how ADHD (especially in women) is also very understudied, there are so many variables we just don't know or understand.

    If you are interested in novel treatments of PTSD, I also recommend looking into blue light therapy. There is some promising results showing a reduction in symptom severity within 6 weeks of daily 30-min blue light exposure in the morning. Here is a systematic review that looks at 4 studies.

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  • [–] 3 points 7 months ago (1 child)

    Ya, it could be better. Maybe a compromise would be to go with EEG machines which are less costly and can probably still differentiate fairly well (maybe).

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  • [–] 4 points 7 months ago

    I would be down with that as long as it’s a viable way to diagnose (I don’t know enough off the top of my head about it).

    Basically anything other than self-report and the clinician’s opinion would be nice.

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  • [–] 1 point 7 months ago

    I wish we (therapists) at least had the option to order an MRI or recommend a doctor orders one in difficult cases (I can do the latter but they will just laugh at me).

    God, that's awful. The most common sense thing to do there is is to use what's availiable (fMRI) when it is, and if availability is the problem, fill the gaps with questionnaires - those who you're sure about might not need an fMRI, but others might. Which you, as a person who's supposed to sign off on the diagnosis, should be able to order.

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