Narrative Review. This page provides the verified citation, abstract, and full-text PDF for the journal article.
Clinical boundary: Rating scales, symptom lists, self-diagnosis, prior labels, and medication response do not prove ADHD. Diagnosis requires developmental and functional evidence plus assessment of alternative and co-occurring conditions.
Publication Details
- Author: Christian Jonathan Haverkampf
- Journal: The Journal of Psychiatry Psychotherapy and Communication
- Publication date: 2022-09-30
- Volume, issue, pages: 11(3), 71–80
- Article type: Narrative Review
Recommended citation: Haverkampf, C. J. (2022). Misdiagnosis of ADHD: Mimics, Comorbidity, and Assessment Pitfalls. The Journal of Psychiatry Psychotherapy and Communication, 11(3), 71–80.
Abstract
Attention problems are common; ADHD is a specific developmental diagnosis. Misdiagnosis occurs when current distractibility, restlessness, poor initiation, or impulsivity is accepted without establishing developmental onset, pervasiveness, impairment, and exclusion of better explanations. The reverse error also occurs when genuine ADHD is attributed entirely to anxiety, depression, personality, poor motivation, or modern technology. This narrative review examines diagnostic pitfalls in adults, including symptom-list matching, anchoring on a self- or prior diagnosis, overreliance on rating scales or medication response, failure to assess impairment, and neglect of collateral or developmental evidence. Mimics and modifiers include sleep deprivation and sleep disorders, anxiety, trauma, depression, bipolar disorder, substance use, medication effects, medical and neurological conditions, learning disorders, autism, and environmental overload. Comorbidity is common, so identifying an alternative does not automatically exclude ADHD. A structured differential uses chronology, episode pattern, context specificity, functional analysis, and response to environmental change. Treatment trials should have predefined outcomes and cannot serve as diagnostic proof. The review proposes language for communicating uncertainty and correcting a label without invalidating the person's difficulties. Accurate diagnosis replaces moral explanations with a testable account while avoiding use of one diagnostic label to explain every difficulty.
Keywords
ADHD; misdiagnosis; adult ADHD; differential diagnosis; screening; sleep; mood disorders; diagnostic error
Full Text
The PDF is searchable and preserves the journal layout and pagination used in the citation.
Related Information
Health Information and Safety
This journal article is educational and research-oriented. It is not a personal diagnosis, treatment plan, medication instruction, crisis service, or substitute for assessment by a suitably qualified clinician who knows the person’s circumstances.
Do not start, stop, or change medication or another treatment solely because of information on this page. New, severe, persistent, or worsening symptoms, or uncertainty about risk, require individual professional assessment.
If there is immediate danger or a risk of harm, contact local emergency services or urgent support. In Ireland, see:
- HSE urgent mental health help
- Mental Health Commission urgent help and support
- Mental health help and support routes
- Website disclaimer
Website copy first made available on 26 August 2026. The journal citation retains the article’s issue date.