What findings of a Mental Status Examination are consistent with a diagnosis of attention deficit hyperactivity disorder (ADHD)?

Updated: Oct 01, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

No physical findings have been well correlated with ADHD.

Mental Status Examination may note the following:

  • Appearance: Most often, appointments are difficult to structure and maintain due to hyperactivity and distractibility. Children with ADHD may present as fidgety, impulsive, and unable to sit still, or they may actively run around the office. Adults with ADHD may be distractible, fidgety, and forgetful.

  • Affect/mood: Affect usually is appropriate and may be elevated, but it should not be euphoric. Mood usually is euthymic, except for periods of low self-esteem and decreased (dysthymic) mood. Mood and affect are not primarily affected by ADHD, although irritability may frequently be associated with ADHD.

  • Speech/thought processes: Speech is of normal rate but may be louder due to impulsivity. Thought processes are goal-directed but may reflect difficulties staying on a topic or task. Evidence of racing thoughts or pressured speech should not be present. These symptoms are more consistent with a manic state (bipolar disorder).

  • Hallucinations or delusions: Not present.

  • Thought content/suicide: Content should be normal, with no evidence of suicidal/homicidal or psychotic symptoms.

  • Cognition: Concentration and storage into recent memory are affected. Patients with ADHD may have difficulty with calculation tasks and recent memory tasks. Orientation, remote memory, or abstraction should not be affected.


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