PMC:2518387 / 6754-9017 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/2518387","sourcedb":"PMC","sourceid":"2518387","source_url":"http://www.ncbi.nlm.nih.gov/pmc/2518387","text":"Medical disorders\nA thorough medical history can be useful to help guide diagnosis since many medical conditions can present with symptoms similar to ADHD. Patients with histories of any one of the following should be more carefully evaluated and referred for other evaluations and possibly other treatments as is necessary: developmental disorders, seizure disorders (petit mal), sleep apnea, hearing and vision problems, thyroid disorders, lead poisoning, and hypoglycemia. Additionally, patients currently taking any medications or with histories of severe drug or alcohol abuse need to be evaluated and treated carefully, since the consumption of some medications and drugs can cause ADHD-like symptoms.\nWhile there are specific symptoms that can help to guide differential diagnosis, this matter is not entirely straight forward since individuals with ADHD are often comorbid with other illnesses. Thus, if a patient is suffering with severe symptoms of other disorders, such as anxiety or depression, we first attempt to address the most severely impairing disorder to determine whether the ADHD symptoms improve. If a patient displays moderate symptoms of other psychiatric disorders, it is often a matter of clinical judgment as to how to proceed.\nIt is very common that adults with ADHD have comorbidities. In a recent large-scale family study 81% of adults with ADHD had at least one comorbid diagnosis, while 56% had at least two comorbid diagnoses (McGough et al 2005). The most common disorders encountered with adult ADHD patients are: substance abuse and d15ependence, mood disorders, anxiety disorders, and personality disorders such as antisocial personality disorder and borderline personality disorder. Multiple studies have demonstrated that up to 50% of adult patients with ADHD have had comorbid substance use problem (Sobanski 2006). Retrospective studies of adults with ADHD have demonstrated that 30%–50% have had one or more episodes of depression, while 40%–60% have had an anxiety disorder throughout their lifespan (Sobanski 2006). Personality disorders and specifically antisocial personality disorder, are seen at increased rates in adults with ADHD (Mannuzza et al 1998). 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