美国国家公共电台 NPR Adult ADHD Can't Be Diagnosed With A Simple Screening Test, Doctors Warn

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DAVID GREENE, HOST:

The World Health Organization has endorsed¹ a six-question screening test for ADHD in adults. Now, this is catching² a lot of people's attention because, with symptoms like distractedness and disorganization, it can be pretty tempting³ to diagnose yourself or others with ADHD. But as NPR's Rebecca Hersher reports, many ADHD researchers say we shouldn't really trust any simple or quick test.

REBECCA HERSHER, BYLINE⁴: The screening test includes questions like - do you procrastinate⁵? - and appears to promise a quick and easy diagnosis⁶. David Goodman is an ADHD specialist at Johns Hopkins University and consultant⁷ for companies that make ADHD drugs. And he says there's nothing quick or easy about diagnosing adult ADHD.

DAVID GOODMAN: The diagnosis gets made in a clinical interview with the patient over the course of an hour or so, tracking the symptoms from childhood into adulthood⁸.

HERSHER: And, he says, especially in adults, docs need to make sure symptoms like distractedness, disorganization and procrastination⁹ aren't coming from some other disorder¹⁰ like anxiety. Dr. Lawrence Diller, a pediatric ADHD specialist, goes one step further, saying the basic definition of ADHD has changed multiple times.

LAWRENCE DILLER: I don't know anymore what ADHD means - literally¹¹. I believe in it. But except for extremes in children, again, it becomes very subjective¹².

HERSHER: Making diagnosis difficult. He says diagnostic tools like the six-question screening are potentially misleading because the symptoms they describe are so ubiquitous. Like, who isn't distracted?

DILLER: In America, if your talents and temperament¹³ don't match your goals and aspirations¹⁴, that incongruity¹⁵ generates a series of feelings or behaviors that match quite nicely the diagnostic criteria¹⁶.

HERSHER: Which makes ADHD meds very popular among Americans. The U.S. is by far the largest consumer of ADHD drugs in the world. And the market is still growing. Alan Schwarz is a former investigative reporter for The New York Times and the author of the book "ADHD Nation." He says there's something more sinister¹⁷ at play, as well.

ALAN SCHWARZ: The six-question screening instrument that was endorsed by the World Health Organization was devised by doctors with a very long history in ADHD. And these are generally men who have been enriched by the pharmaceutical¹⁸ industry in order to churn out research and churn out things like this that expand the ADHD market.

HERSHER: So what options are available for adults who are diagnosed with ADHD? There are amphetamines like Adderall. Adults are generally prescribed extended-release versions of those pills because they're more difficult to abuse. Antidepressants have also been shown to help with impulsivity¹⁹ and hyperactivity. And there are options without drugs, like cognitive²⁰ behavioral therapy. The upshot - your best bet is to talk to a specialist about what treatment works best for you. Rebecca Hersher, NPR News.