• Atencion primaria · Mar 2021

    Multicenter Study

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

    • Maria Eugenia de la Viuda Suárez, Julio César Alonso Lorenzo, Francisco José Ruiz Jiménez, and Maria Carmen Luciano Soriano.
    • Clinical Psychologist, Public Mental Health System in Asturias (SESPA), Spain. Electronic address: euvisu@hotmail.com.
    • Aten Primaria. 2021 Mar 1; 53 (3): 101945.

    IntroductionAttention 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.Goalto describe and compare current clinical ADHD assessment processes in public health system in two cohorts and analyze variables related to final diagnosis.DesignDescriptive, multicenter, longitudinal (retrospective-prospective).Locationprimary care (PC) centers in Oviedo, Asturias (Spain).Participantsa Spanish clinical ADHD symptomatic sample (n=134) from two cohorts (2004 and 2009).Variablesclinical 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.Resultsthe 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).Discussionsthe 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.Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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