(PSYCHIATRIC TIMES) - A psychologist refers numerous patients with the diagnosis of adult attention deficit hyperactivity disorder (ADHD) to me for prescriptions for extended-release methylphenidate. There has been no psychiatric evaluation. To help me feel more confident prescribing this medication in such a setting, can you describe the characteristics that distinguish adult ADHD from bipolar disorder?
— Rosemary Selinger, MD
Grants Pass, Ore It is imperative for any physician asked to prescribe for a psychologist to ensure adequate workup of the condition, be it ADHD, major depressive disorder, bipolar disorder, anxiety, or any other disorder. In part, validation depends on the physician’s familiarity with the psychologist. However, in instances where such confidence has not developed, it is wise to do the following: 1. Take a brief ADHD inventory (which should take about 10 minutes). The distinguishing features of adult ADHD are:
* Either inattention, hyperactivity/impulsivity, or both—verified with an adult screening tool to confirm a sufficient level of symptoms. An adult ADHD self-report scale, such as the one developed by the World Health Organization,1 is very useful here.
* Symptoms present since age 6 with no waxing and waning.
* No other cause for the inattention/hyperactivity.
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