eMedicine Specialties > Psychiatry > Child

Attention Deficit Hyperactivity Disorder: Differential Diagnoses & Workup

Author: Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Contributor Information and Disclosures

Updated: Nov 23, 2009

Differential Diagnoses

Anxiety Disorders
Posttraumatic Stress Disorder
Bipolar Affective Disorder
Sleep Disorders
Depression
Dysthymic Disorder
Hyperthyroidism

Other Problems to Be Considered

Generalized resistance to thyroid hormone
Learning disorders
Malnutrition
Medication-induced hyperactivity
Metabolic disturbances
Hearing impairment

Workup

Laboratory Studies

  • The diagnosis of attention deficit hyperactivity disorder (ADHD) is based on clinical evaluation. No laboratory-based medical tests are available to confirm the diagnosis.
  • Basic laboratory studies that may help confirm diagnosis and aid in treatment are as follows:
    • Serum CBC count with differential
    • Electrolyte levels
    • Liver function tests (before beginning stimulant therapy)
    • Thyroid function tests

Imaging Studies

Brain imaging, such as functional MRI or single photon emission computed tomography (SPECT) scans have been useful for research, but no clinical indication exists for these procedures because the diagnosis is clinical.

Other Tests

  • Psychological testing
    • The Conners Parent-Teacher Rating Scale is a questionnaire that can be given to both the parents and the child's teachers.
    • Barkley Home Situations Questionnaire may be useful.
    • The Wender Utah Rating Scale may be helpful in diagnosing ADHD in adults.
    • The Continuous Performance Tests (CPTs) are computer-based tasks that often are used to test attention and may be used in conjunction with clinical information to make a diagnosis. A currently popular example is the Test of Variable Attention (TOVA). While these tests can be supportive of the diagnosis in a full clinical evaluation, they have low sensitivity and specificity and should not be the sole basis for diagnosis.
  • Vision and hearing should be checked.

More on Attention Deficit Hyperactivity Disorder

Overview: Attention Deficit Hyperactivity Disorder
Differential Diagnoses & Workup: Attention Deficit Hyperactivity Disorder
Treatment & Medication: Attention Deficit Hyperactivity Disorder
Follow-up: Attention Deficit Hyperactivity Disorder
References
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Further Reading

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Keywords

ADHD, attention deficit hyperactivity disorder, hyperactive, hyperactivity, attention deficit disorder, ADD, hyperactive syndrome, minimal brain dysfunction, inattention, distractibility, adult attention deficit hyperactivity disorder, adult attention deficit disorder, adult hyperactivity, adult ADHD, adult ADD, dopamine, norepinephrine, predominantly hyperactive ADHD, predominantly inattentive ADHD, combined ADHD, impulsivity, Tourette syndrome, Tourette disease, Tourette's syndrome, Tourette's disease, bipolar disorder

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Contributor Information and Disclosures

Author

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

Medical Editor

Denis F Darko, MD, Executive Director, Clinical Research and Development, Global Neuroscience, AstraZeneca
Denis F Darko, MD is a member of the following medical societies: American College of Physicians and American Psychiatric Association
Disclosure: AstraZeneca Salary Management position

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eduardo Dunayevich, MD, Adjunct Assistant Professor, Department of Psychiatry, University of Cincinnati; Clinical Research Physician, Neuroscience, Lilly Research Laboratories
Eduardo Dunayevich, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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