Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?

INTRODUCTION: Attention deficit and hyperactivity disorder (ADHD) rates vary between 1% and 20% depending on the type of diagnosis guide used, the test used in the assessment, psychosocial factors, and professional in charge of the assessment. GOAL: to describe and compare current clinical ADHD asse...

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Autores principales: de la Viuda Suárez, Maria Eugenia, Alonso Lorenzo, Julio César, Ruiz Jiménez, Francisco José, Luciano Soriano, Maria Carmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873649/
https://www.ncbi.nlm.nih.gov/pubmed/33548739
http://dx.doi.org/10.1016/j.aprim.2020.10.004
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author de la Viuda Suárez, Maria Eugenia
Alonso Lorenzo, Julio César
Ruiz Jiménez, Francisco José
Luciano Soriano, Maria Carmen
author_facet de la Viuda Suárez, Maria Eugenia
Alonso Lorenzo, Julio César
Ruiz Jiménez, Francisco José
Luciano Soriano, Maria Carmen
author_sort de la Viuda Suárez, Maria Eugenia
collection PubMed
description INTRODUCTION: Attention deficit and hyperactivity disorder (ADHD) rates vary between 1% and 20% depending on the type of diagnosis guide used, the test used in the assessment, psychosocial factors, and professional in charge of the assessment. GOAL: to describe and compare current clinical ADHD assessment processes in public health system in two cohorts and analyze variables related to final diagnosis. DESIGN: Descriptive, multicenter, longitudinal (retrospective-prospective). LOCATION: primary care (PC) centers in Oviedo, Asturias (Spain). PARTICIPANTS: a Spanish clinical ADHD symptomatic sample (n = 134) from two cohorts (2004 and 2009). VARIABLES: clinical professional in charge of ADHD assessment (PC, mental health professional [MH], neuropediatrician [NP]), type of test used in the assessment, confirmation/disconfirmation of ADHD diagnosis, and final diagnosis. RESULTS: the use of symptoms checklists and the assessments in charge of primary care (PC) and neuropediatrician (NP) professionals show an upward trend from 2004 to 2009. ADHD final diagnosis shows low inter-professional (NP-MH) reliability (kappa = 0.39). Final diagnoses for the same symptoms are different depending on the professional (NP or MH). DISCUSSIONS: the professional in charge of the assessment appears to be a relevant variable for the final diagnosis. ADHD diagnosis criteria seem not to be clear. This data suggests that ADHD diagnosis must be used with caution to ensure good quality clinical standards when assessing and treating ADHD symptoms. Assessments supported by symptoms checklists and performed by NP or PC could be contributing factors to an ADHD over-diagnosis tendency.
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spelling pubmed-78736492021-02-17 Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible? de la Viuda Suárez, Maria Eugenia Alonso Lorenzo, Julio César Ruiz Jiménez, Francisco José Luciano Soriano, Maria Carmen Aten Primaria Original Article INTRODUCTION: Attention deficit and hyperactivity disorder (ADHD) rates vary between 1% and 20% depending on the type of diagnosis guide used, the test used in the assessment, psychosocial factors, and professional in charge of the assessment. GOAL: to describe and compare current clinical ADHD assessment processes in public health system in two cohorts and analyze variables related to final diagnosis. DESIGN: Descriptive, multicenter, longitudinal (retrospective-prospective). LOCATION: primary care (PC) centers in Oviedo, Asturias (Spain). PARTICIPANTS: a Spanish clinical ADHD symptomatic sample (n = 134) from two cohorts (2004 and 2009). VARIABLES: clinical professional in charge of ADHD assessment (PC, mental health professional [MH], neuropediatrician [NP]), type of test used in the assessment, confirmation/disconfirmation of ADHD diagnosis, and final diagnosis. RESULTS: the use of symptoms checklists and the assessments in charge of primary care (PC) and neuropediatrician (NP) professionals show an upward trend from 2004 to 2009. ADHD final diagnosis shows low inter-professional (NP-MH) reliability (kappa = 0.39). Final diagnoses for the same symptoms are different depending on the professional (NP or MH). DISCUSSIONS: the professional in charge of the assessment appears to be a relevant variable for the final diagnosis. ADHD diagnosis criteria seem not to be clear. This data suggests that ADHD diagnosis must be used with caution to ensure good quality clinical standards when assessing and treating ADHD symptoms. Assessments supported by symptoms checklists and performed by NP or PC could be contributing factors to an ADHD over-diagnosis tendency. Elsevier 2021-03 2021-02-04 /pmc/articles/PMC7873649/ /pubmed/33548739 http://dx.doi.org/10.1016/j.aprim.2020.10.004 Text en © 2021 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
de la Viuda Suárez, Maria Eugenia
Alonso Lorenzo, Julio César
Ruiz Jiménez, Francisco José
Luciano Soriano, Maria Carmen
Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title_full Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title_fullStr Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title_full_unstemmed Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title_short Assessing ADHD symptoms in clinical public practice: Is a reliable final diagnosis possible?
title_sort assessing adhd symptoms in clinical public practice: is a reliable final diagnosis possible?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873649/
https://www.ncbi.nlm.nih.gov/pubmed/33548739
http://dx.doi.org/10.1016/j.aprim.2020.10.004
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