Mimics of ADHD: Medical and neurological conditions

Phillip L. Pearl, Roy E Weiss, Mark A. Stein

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations


Diagnostic process The process of differential diagnosis involves distinguishing between the various disorders which may present with similar symptoms, and sorting out the different possible etiological factors that may lead to the same symptom [1]. Since many of the symptoms of attention-deficit hyperactivity disorder (ADHD) overlap with a wide range of psychiatric and medical disorders, the evaluation process should begin with a more general approach to identify potential medical mimics as well as comorbid disorders which will affect the diagnosis and treatment plan. Although ADHD can be diagnosed at any age, the course is typically that of a developmental disorder with onset of symptoms during childhood. Suspicion of a medical mimic is increased, however, when symptoms occur acutely or there is a profound change or deterioration in function. In such cases, alternative explanations or “medical mimics” are more likely and should be more extensively pursued. Non-familial ADHD, or “ADHD-plus” syndromes where a patient is compromised by ADHD symptomatology plus other prominent deficits of cognitive processing or neurological functioning, should trigger a search for separate, more primary disorders which include ADHD symptoms as part of their typical presentation (e.g., neurofibromatosis, fetal alcohol syndrome, thyroid disorders including hyper- and hypothyroidism, intellectual deficiency, lead poisoning, obstructive sleep apnea, Tourette syndrome [TS]). In assessment of such patients one should be certain that the symptoms of ADHD are not associated with concomitant use of other medications, the side effects of which would have similar symptoms of inattentiveness and impaired cognitive function.

Original languageEnglish (US)
Title of host publicationAttention-Deficit Hyperactivity Disorder in Adults and Children
PublisherCambridge University Press
Number of pages11
ISBN (Print)9781139035491, 9780521113984
StatePublished - Jan 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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