Diagnosing and monitoring adult ADHD

It is often thought that attention-deficit/hyperactivity disorder (ADHD) is a condition from which only children suffer. The latest studies show that it is, in fact, a lifelong disorder and that adults can also be affected. Dr Lars Davidsson discusses the problem and a new test that no enables doctors to diagnose and manage the condition far more effectively.

Attention-deficit/hyperactivity disorder does not only affect children

For a long time, attention deficit/hyperactivity disorder (ADHD) was considered to be rather rare condition only affecting children and adolescents. However, during the last decade, ADHD has been largely reconceptualised as a lifelong disorder and not merely a condition of childhood.

ADHD is characterised by deficits in sustained attention or persistence, resistance to distraction, voluntary motor inhibition, and the regulation of activity level relative to same-aged peers. Originating in early childhood, ADHD is a relatively persistent condition. There is a difference of opinions as to the extent the condition persists into adulthood. However, it has been stated that up to 80% of diagnosed children continuing to meet diagnostic criteria in adolescence and up to 67% continue to have clinically significant symptoms of the disorder in adulthood.

Determining ADHD in adults can be difficult

Assessing whether an adult has ADHD can be difficult considering that unrelated anxiety, dysphoria and depression often occur simultaneously. Behavioural manifestations of inattention and hyperactivity such as disorganisation, restlessness, and distractibility are normal human characteristics that are also symptoms of many conditions that commonly occur at the same time ADHD. Often these symptoms are assessed using highly subjective behavioural rating scales. The NICE guidelines are extensive but, in essence, recommend that the diagnosis be made on the basis of a thorough clinical interview, including objective developmental information when possible. There is, in principal, no difference in the diagnosis of children, adolescents or adults and the treatment is the same, usually a a combination of drugs, psychotherapy (cognitive behaviour therapy) and psychosocial support.

The use of Qb testing for attention deficit/hyperactivity disorder

The QbTest is widely used in Europe and is being used in a growing number of UK centres. It is an objective tool that measures all three core signs of ADHD – inattention, impulsivity and hyperactivity in patients between 6 and 55 years of age.

The test will, together with other clinical information, provide a much better foundation for the assessment of ADHD. It will also help to guide the selection and evaluation of individually tailored treatment.

What is a QbTest for ADHD?

A QbTest is a computer-based test that combines a test of attention ability with a movement analysis based on an infrared measurement system. Test results are assembled into a report and compared with norm data from other people of the same sex and age. This way the tester can see how the patient reacts when concentrating on a task in comparison with people who do not have ADHD.

Why should a patient take a QbTest?

The QbTest will determine:

  • If you have ADHD
  • If ADHD medication will help you
  • What medicine and what dosage works best
  • If a form of treatment without medication is preferable for you

How does the Qb test work?

The test is done in front of a computer screen. The test equipment consists of an infrared camera, a camera marker and a response button. During the test, a number of symbols are shown at regular intervals on the computer screen. A responder button should be pushed when the same symbol is repeated.

This is a common method for measuring attention and impulsivity, and at the same time the movement pattern will be recorded. The test is very easy to perform and will be ready in 15 minutes for children and 20 minutes for adolescents. When the test is completed, the investigator will discuss the test results with the patient.

QB testing at Angloeuropeanclinic

Testing is currently available at the Southend-on-Sea clinic in Essex and will shortly be available at the Harley Street Clinic and the Chelmsford Priory Hospital. A minimum of two tests are required, one before and one after treatment.

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Diagnosing and monitoring adult ADHD
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