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Diseases » ADHD » Misdiagnosis
 

Misdiagnosis of ADHD

Misdiagnosis of ADHD

A diagnosis of ADHD may missed because its symptoms can mimic symptoms of such conditions as anxiety disorder, depression, conduct disorder, and learning disabilities. It is important to understand that although these disorders are separate conditions from ADHD, they often accompany ADHD.

The symptoms of ADHD can also mimic such conditions as petit mal seizures, diabetes, and conditions that can affect hearing or vision. ,

The term ADHD is often interchanged in common usage with the term "hyperactivity" and is frequently misused in describing unruly children without a proper diagnosis. This is partially because the symptoms of ADHD are common and are seen in most children at one time or another in their lives.

Children are unique and energetic individuals who develop at different rates. Learning to control their behavior and developing concentration skills is an evolving process for most children, and having a "melt down" or a temper tantrum or being excessively excited does not automatically warrant a diagnosis of ADHD.

It is not uncommon for adults with ADHD to have struggled most of their lives with the disorder without a diagnosis. They may be living chaotic lives, and self medicating or using alcohol and drugs in an attempt to cope. Shame or embarrassment about symptoms can also result in a delay in seeking medical care and a diagnosis....more about ADHD »

ADHD misdiagnosis: The term ADHD is often interchanged in common usage with the term "hyperactivity" and is frequently misused in describing children without a proper diagnosis. This is partially because the symptoms of ADHD can be common and are seen in most children at one time or another in their lives.

Children are unique and energetic individuals who develop at different rates. Learning to control their behavior and developing concentration skills is an evolving process for most children, and having a "melt down" or a temper tantrum or being excessively excited occasionally does not automatically warrant a diagnosis of ADHD.

Another misnomer about ADHD is that children with ADHD are "spoiled" or that they "just need a good spanking" or eat too much sugar and caffeine. Although caffeine may have some impact on energy levels, ADHD is a true medical disorder and is not cause purely by "bad parenting" or too much candy. Current studies have not linked the use of sugar to a difference in behavior....more about ADHD »

Alternative diagnoses list for ADHD:

For a diagnosis of ADHD, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for ADHD:

Diseases for which ADHD may be an alternative diagnosis

The other diseases for which ADHD is listed as a possible alternative diagnosis in their lists include:

Rare Types of ADHD:

ADHD: Medical Mistakes

Related medical mistakes may include:

ADHD: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Discussion of diagnosis/misdiagnosis of ADHD:

A child or adolescent who appears to be depressed and exhibits ADHD-like symptoms that are very severe, with excessive temper outbursts and mood changes, should be evaluated by a psychiatrist or psychologist with experience in bipolar disorder, particularly if there is a family history of the illness. This evaluation is especially important since psychostimulant medications, often prescribed for ADHD, may worsen manic symptoms. There is also limited evidence suggesting that some of the symptoms of ADHD may be a forerunner of full-blown mania.38 (Source: excerpt from Depression in Children and Adolescents A Fact Sheet for Physicians: NIMH)

Common Misdiagnoses and ADHD

Mild worm infections undiagnosed in children: Human worm infestations, esp. threadworm, can be overlooked in some cases, because it may cause only mild or even absent symptoms. Although the most common symptoms are anal itch (or vaginal itch), which are obvious in severe cases, milder conditions may fail to be noticed in children. In particular, it may interfere with the child's good night's sleep. Threadworm is a condition to consider in children with symptoms such as bedwetting (enuresis), difficulty sleeping, irritability, or other sleeping symptoms. Visual inspection of the region can often see the threadworms, at night when they are active, but they can also be missed this way, and multiple inspections can be warranted if worms are suspected. See the introduction to threadworm.

Parental fears about toddler behavior often unfounded: There are many behaviors in infants and toddlers that may give rise to a fear that the child has some form of mental health condition. In particular, there is a loss of fear of autism or ADHD in parents. However, parents should understand that the chances are higher that it's part of normal development, and perhaps just a "cute behavior" rather than a serious condition. Although parents should be vigilant about monitoring all aspects of their child's development and mental health, they should also take care not to over-worry and miss out on some of the delights of parenthood. For example, a young child that screams when you open his car door to take him out, then makes you put him back into the car to repeat it, so that he can open the car door himself, is not necessarily showing signs of autism or OCD, nor indeed any mental illness. There is a small possibility that it's an abnormality (a chance that increases with age of the child), but it's also the type of behavior seen in many normal children. See the introduction to autism and introduction to ADHD.

Rare epilepsy misdiagnosed as ADHD: The less common disorder of temporal lobe epilepsy is a type of epilepsy without physical seizures. Some patients suffer from hyperactivity and similar symptoms, making a misdiagnosis of ADHD a possibility. See temporal lobe epilepsy and ADHD.

Various conditions misdiagnosed as ADHD: The hyperactivity type symptoms that are often diagnosed as ADHD, can also be caused by a number of physical conditions, as reported in the book A Dose of Sanity. Some possibilities are chronic long-term exposure to low-level carbon monoxide (see carbon monoxide poisoning), lead poisoning, anemia, brain lesions, parasite infestation, low calcium, low glucose levels (hypoglycemia), and "tight underwear".

ADHD diagnosis overlooked hidden nutritional disorder: The book "A Dose of Sanity" reports on a case of a boy diagnosed with ADHD and receiving Ritalin. His symptoms included tiredness, irritability, poor growth, and eating dirt and unusual foods (a symptom called "pica"). The corrected diagnosis was iron-deficiency anemia.

Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

Mesenteric adenitis misdiagnosed as appendicitis in children: Because appendicitis is one of the more feared conditions for a child with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for children with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

Blood pressure cuffs misdiagnose hypertension in children: One known misdiagnosis issue with hyperension, arises in relation to the simple equipment used to test blood pressure. The "cuff" around the arm to measure blood pressure can simply be too small to accurately test a child's blood pressure. This can lead to an incorrect diagnosis of a child with hypertension. The problem even has a name unofficially: "small cuff syndrome". See misdiagnosis of hypertension.

ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in children is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA). See misdiagnosis of ADHD or symptoms of ADHD.

Bipolar disorder misdiagosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist. See misdiagnosis of bipolar disorder.

Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis. See misdiagnosis of eating disorders or symptoms of eating disorders.

Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked. See misdiagnosis of depression or symptoms of depression.

Children with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in children. See misdiagnosis of migraine or introduction to migraine.

Undiagnosed anxiety disorders related to depression: Patients with depression (see symptoms of depression) may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression. See misdiagnosis of depression or misdiagnosis of anxiety disorders.

Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis). See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.

ADHD: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose ADHD

Failure to diagnose ADHD may be associated with the following:

  • The difficulty with diagnosing ADHD is that there is no definitive, fool-proof method of testing for the condition
  • A large percentage of patients with ADHD symptoms that persist into adulthood end up having substance-use disorders
  • Female sufferers of ADHD are more likely to be undiagnosed as the condition tends to occur more often in males
  • Female ADHD patients are less likely to act out than males and are therefore less likely to be diagnosed
  • There are a range of personality types and ranges of behaviour which may occur in ADHD patients which makes it all the more difficult to diagnose. Not all ADHD sufferers are hyperactive
  • Undiagnosed females tend to deteriorate after they have children because they are less able to keep up with the increased organization required when having a family
  • Failure to diagnose ADHD may result in repercussions such as increased divorce rates, unemployment and motor vehicle accidents as well as increased healthcare costs
  • Undiagnosed adults tend to have low self-esteem, poor social skills, frequent job changes and lower rates of professional employment
  • Many adults with psychiatric disorders tend to have undiagnosed ADHD as well
  • Undiagnosed ADHD in adults may be less likely to be diagnosed as adults are in general more capable of controlling their behaviors which can hide any problems they are having
  • Children who suffered ADHD as a child are more likely to suffer juvenile delinquency and problems with the law as an adult
  • Failure to diagnose ADHD in children can result in poor school performance
  • Undiagnosed teenage and adult ADHD sufferers are much more likely to suffer accidents and injuries than people without the condition

Notes On Hidden Causes Of ADHD

The following may be hidden causes of ADHD:

Notes On Wrong Diagnosis Of ADHD

Wrong diagnosis of ADHD may be associated with the following:

  • It is generally considered inappropriate to diagnose a child under the age of 4 with ADHD
  • Some health professionals consider ADHD to be overdiagnosed leading to unnecessary treatment and stigmatisation
  • ADHD patients often have one or more co-existing psychiatric disorders such as anxiety disorder, depression, bipolar disorder and conduct disorder. This can make it difficult to ascertain whether a patient has ADHD as well as another disorder or whether it is a condition that appears to mimic the symptoms of ADHD. For example, drug abuse, anxiety and OCD may be misdiagnosed as ADHD
  • Studies indicate that ADHD tends to be overdiagnosed
  • Misdiagnosis of ADHD is increasing as patients are not being diagnosed by experts in the field (such as child psychologists)
  • Not all hyperactive, inattentive or impulsive children have ADHD

Complications Of Misdiagnosis Of ADHD

The following may be complications of misdiagnosis of ADHD:

  • Bipolar patients who are misdiagnosed with ADHD often undergo deterioration in behaviour when medication is used

Other Notes On Misdiagnosis Of ADHD

  • ADHD is usually present from infancy
  • A quarter of children with ADHD also tend to have learning disabilities
  • Child and adult ADHD sufferers tend to have sleeping disorders
  • Generalized observations have noticed a link between ADHD and night-time bed-wetting
  • Ritalin use during childhood to treat ADHD may increase the risk of depression in adulthood
  • Many primary care physicians feel they aren't confident with diagnosing ADHD in adults
  • Some authorities believe that ADHD is not a real disorder, especially since the exact causes and etiology of the condition has not yet been determined

Medical news summaries about misdiagnosis of ADHD:

The following medical news items are relevant to misdiagnosis of ADHD:

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of ADHD or confirming a diagnosis of ADHD, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of ADHD may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of ADHD. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.

 

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