No evidence ADHD is being over-diagnosed, say experts

https://lemmus.org/post/20644289

My cousin was diagnosed by a brain scan. She signed up to be part of a clinical trial for something else, got kicked out of the trial because her fMRI showed she had ADHD.

So if we can literally scan someone’s brain and diagnose them from a picture instead of all these vague “describe your symptom” guessing… why don’t we?

It’s quite costly to run an fMRI. Not needed if you can get the same results more or less from a questionnaire.

In my professional experience, it can be hard to tell between ADHD symptoms and CPTSD symptoms. The checklist is not a great way to diagnose people. We usually do a lot more assessments, I also use a computerized test to measure reaction time and error commission.

I wish we (therapists) at least had the option to order an MRI or recommend a doctor orders one in difficult cases (I can do the latter but they will just laugh at me).

Do you know if there any studies on whether the effects of the medicine used for ADHD could have similar positive effects on people with CPTSD?

Great question! To my knowledge, they are just starting to look into it, but with PTSD specifically, not CPTSD. There is this case study (n=1) and this pilot study (n=32) that show promise. They are recruiting people for more testing.

Preliminary evidence shows that it does help - and it makes sense. If cognitive deficits from PTSD are a result of an impaired executive function, then stimulants would help with those particular symptoms, much like in ADHD.

Here’s the thing though - the US healthcare system still doesn’t even have CPTSD as a diagnosis, so there is not too much research happening on the topic here. Considering how ADHD (especially in women) is also very understudied, there are so many variables we just don’t know or understand.

If you are interested in novel treatments of PTSD, I also recommend looking into blue light therapy. There is some promising results showing a reduction in symptom severity within 6 weeks of daily 30-min blue light exposure in the morning. Here is a systematic review that looks at 4 studies.

A new player in the field: Methylphenidate in post-traumatic stress disorder treatment

Currently available psychotherapies and psychotropic drugs for post-traumatic stress disorder (PTSD) are poorly effective in a substantial proportion of patients. Dopaminergic dysfunction plays a prominent role in the pathophysiology of PTSD: ...

PubMed Central (PMC)