Identifying Potential Cases of Comorbid ADHD with Depression, Conduct Disorder and other Diagnoses. Using a Broad Based Screening.

Rationale:

Children and adolescents experiencing difficulties with school, family or activities of daily living often present at mental health agencies, physicians` offices or other service providers seeking assessment and intervention. Missing ADHD diagnoses and other comorbid issues could contribute to long term issues.

Objective:

To determine if conducting a broad based mental health screening of children and adolescents who are seeking care can identify ADHD symptomology.

Methods:

Child and adolescent closed cases from an average sized community mental health agency in the United States, were reviewed (n=2760). Responses to the Pediatric Symptom Checklist and clinical case notes were reviewed. ADHD criteria were separated for this analysis.

Results:

Screening results and case notes indicated that 53% of all cases met clinical criteria for ADHD diagnosis. Screenings indicative of a need to assess for ADHD were routinely ignored in cases where depression or conduct disorders were diagnosed. In cases of depression, 41% met or exceeded the screening cutoff score for ADHD, while only 3% of those with a diagnosis of depression also received assessment and subsequent diagnosis of ADHD. With conduct disorders, 57% of the cases met or exceeded the screening cutoff score for ADHD, while only 15% received assessment and subsequent concurrent diagnosis.

Conclusion:

While ADHD may not be the presenting problem, the effects of ADHD symptoms and behaviors on concurrent diagnoses can be significant. Missing comorbid ADHD diagnoses can impact long term outcomes and overall mental health. Screening and subsequent assessment/diagnosis of ADHD as standard practice is recommended.