A description of the characteristics that distinguish adult ADHD from bipolar disorder.
A psychologist refers numerous patients with the diagnosis of adult attentiondeficit hyperactivity disorder (ADHD) to me for prescriptions for extended-releasemethylphenidate. There has been no psychiatric evaluation. To help mefeel more confident prescribing this medication in such a setting, can you describethe characteristics that distinguish adult ADHD from bipolar disorder?
- Rosemary Selinger, MD
Grants Pass, OreIt is imperative for any physician asked to prescribe for a psychologist toensure adequate workup of the condition, be it ADHD, major depressivedisorder, bipolar disorder, anxiety, or any other disorder. In part, validationdepends on the physician's familiarity with the psychologist. However,in instances where such confidence has not developed, it is wise to dothe following:1. Take a brief ADHD inventory (which should take about 10 minutes).The distinguishing features of adult ADHD are:
It is important to ask about psychiatric comorbidities because theseoccur in the majority of patients with ADHD. Bipolar disorder has a particularaffinity with ADHD. The distinguishing features of bipolar disorder are:
Even when bipolar disorder and ADHD co-occur, the diagnosis ofADHD is seldom difficult; however, if a patient is in a manic phase, diagnosingADHD will require more clinical acumen-and possibly more time.
Administer a mood disorder questionnaire
to anyone in whombipolar disorder is suspected.
- Paul P. Doghramji, MD
World Health Organization. Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist. Available at:
[PDF]. Accessed April 17, 2006.
Hirshfeld RM, Williams JB, Spitzer RL, et al. Primary Care Mood Disorders Questionnaire. Available at
[DOC]. Accessed April 17, 2006.