Diagnosing ADHD in adults in randomized controlled studies: a scoping review
Abstract Background The diagnosis of ADHD in adults is on the rise. Applying the ADHD diagnosis, which originally was described in children, to adults has involved a “subjectivization” of some of the diagnostic criteria, i.e., some behavioral features (signs) in children have become experiences (s...
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Cambridge University Press
2025-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933825024472/type/journal_article |
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| author | Igor Studart Mads Gram Henriksen Julie Nordgaard |
| author_facet | Igor Studart Mads Gram Henriksen Julie Nordgaard |
| author_sort | Igor Studart |
| collection | DOAJ |
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Abstract
Background
The diagnosis of ADHD in adults is on the rise. Applying the ADHD diagnosis, which originally was described in children, to adults has involved a “subjectivization” of some of the diagnostic criteria, i.e., some behavioral features (signs) in children have become experiences (symptoms) in adults. These issues raise the question of how ADHD is best diagnosed in adults? Thus, we examined how ADHD is diagnosed in adults in research.
Methods
A review of how ADHD is diagnosed in adults in randomized controlled studies (RCTs).
Results
We include 292 RCTs. We found substantial variation and no consensus about the diagnostic method. More than half of the studies did not seem to include an assessment of general psychopathology, and only in 35% of studies was the ADHD diagnosis allocated by psychiatrists or psychologist. More than half of the studies included patients with psychiatric comorbidity.
Conclusion
These findings raise concerns about the validity of the ADHD diagnosis in many of the included RCTs. It is worrying that securing a reasonably accurate diagnosis is not prioritized in more than half of the studies. If neither clinicians nor researchers can rely on the basic fact the patients in scientific studies diagnostically resemble the patients they are facing, scientific studies risk losing their clinical relevance. Since RCTs can lead to changes in clinical practice, they must be conducted carefully. To advance research on adult ADHD, the quality of the diagnostic assessment must be prioritized, requiring comprehensive differential diagnosis by a skilled psychiatrist or psychologist.
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| format | Article |
| id | doaj-art-1f3729324cfb4f3bbe780c6c8a0fbf34 |
| institution | OA Journals |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-1f3729324cfb4f3bbe780c6c8a0fbf342025-08-20T02:34:47ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.2447Diagnosing ADHD in adults in randomized controlled studies: a scoping reviewIgor Studart0https://orcid.org/0000-0001-6462-4187Mads Gram Henriksen1https://orcid.org/0000-0002-2103-7318Julie Nordgaard2https://orcid.org/0000-0003-2492-9124Institute of Psychiatry, University of São Paulo, Sao Paulo, BrazilCenter for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark Psychiatry East, Region Zealand, Roskilde, DenmarkPsychiatry East, Region Zealand, Roskilde, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Abstract Background The diagnosis of ADHD in adults is on the rise. Applying the ADHD diagnosis, which originally was described in children, to adults has involved a “subjectivization” of some of the diagnostic criteria, i.e., some behavioral features (signs) in children have become experiences (symptoms) in adults. These issues raise the question of how ADHD is best diagnosed in adults? Thus, we examined how ADHD is diagnosed in adults in research. Methods A review of how ADHD is diagnosed in adults in randomized controlled studies (RCTs). Results We include 292 RCTs. We found substantial variation and no consensus about the diagnostic method. More than half of the studies did not seem to include an assessment of general psychopathology, and only in 35% of studies was the ADHD diagnosis allocated by psychiatrists or psychologist. More than half of the studies included patients with psychiatric comorbidity. Conclusion These findings raise concerns about the validity of the ADHD diagnosis in many of the included RCTs. It is worrying that securing a reasonably accurate diagnosis is not prioritized in more than half of the studies. If neither clinicians nor researchers can rely on the basic fact the patients in scientific studies diagnostically resemble the patients they are facing, scientific studies risk losing their clinical relevance. Since RCTs can lead to changes in clinical practice, they must be conducted carefully. To advance research on adult ADHD, the quality of the diagnostic assessment must be prioritized, requiring comprehensive differential diagnosis by a skilled psychiatrist or psychologist. https://www.cambridge.org/core/product/identifier/S0924933825024472/type/journal_articlecomorbiditydiagnostic criteriamethodologypsychopathology |
| spellingShingle | Igor Studart Mads Gram Henriksen Julie Nordgaard Diagnosing ADHD in adults in randomized controlled studies: a scoping review European Psychiatry comorbidity diagnostic criteria methodology psychopathology |
| title | Diagnosing ADHD in adults in randomized controlled studies: a scoping review |
| title_full | Diagnosing ADHD in adults in randomized controlled studies: a scoping review |
| title_fullStr | Diagnosing ADHD in adults in randomized controlled studies: a scoping review |
| title_full_unstemmed | Diagnosing ADHD in adults in randomized controlled studies: a scoping review |
| title_short | Diagnosing ADHD in adults in randomized controlled studies: a scoping review |
| title_sort | diagnosing adhd in adults in randomized controlled studies a scoping review |
| topic | comorbidity diagnostic criteria methodology psychopathology |
| url | https://www.cambridge.org/core/product/identifier/S0924933825024472/type/journal_article |
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