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The neuropsychiatric approach to diagnosing and treating adults with ADHD

Published online by Cambridge University Press:  26 August 2025

S. Lodhi*
Affiliation:
Department of Psychiatry, Harvard Medical School, Boston, United States

Abstract

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Background

Attention-deficit/hyperactivity disorder (ADHD) in adults often presents with nonspecific symptoms that can be obscured by years of compensatory mechanisms and comorbid conditions. Traditional diagnostic approaches may fall short in capturing the nuanced presentation of ADHD in previously undiagnosed adults, leading to potential misdiagnosis or delayed treatment. This talk presents a comprehensive clinical framework for evaluating adult ADHD that integrates structured assessment protocols with thorough clinical investigation.

Methods

Our diagnostic model employs a multi-stage evaluation process that includes: (1) comprehensive pre-interview rating scales, (2) in-depth clinical interviews focusing on lifetime symptom presentation and functional impact, (3) systematic gathering of collateral information, and (4) administration of validated assessment instruments with embedded validity scales. The evaluation protocol emphasizes the assessment of executive function, emotional regulation, and adaptive behaviors developed throughout adulthood.

Discussion

This approach represents a significant advancement in adult ADHD diagnosis by incorporating validated assessment tools with thorough clinical investigation. The model’s emphasis on lifetime symptom patterns, adaptive behaviors, and compensatory mechanisms provides crucial insights into how ADHD manifests in adults who have developed various coping strategies throughout their lives. Furthermore, the integration of multiple data sources with patient insights facilitates better treatment engagement and outcomes.

Conclusion

The proposed comprehensive evaluation framework offers a more sophisticated and nuanced approach to diagnosing ADHD in previously undiagnosed adults. By combining validated assessment instruments with thorough clinical investigation and collateral information, this model enhances diagnostic accuracy and treatment planning. Our findings suggest that this approach not only improves diagnostic precision but also provides valuable insights into the developmental trajectory of ADHD, leading to more personalized and effective treatment strategies.

Keywords

Adult ADHD, clinical evaluation, executive function, compensatory mechanisms, diagnostic precision

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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