Assessing Child Maladaptive Behaviors: Distinguishing Between Attention-Deficit/Hyperactivity Disorder (ADHD) and Depression

There are several conditions with overlapping diagnostic criteria that can look similar to ADHD. Diagnostic evaluations can help you identify the problem correctly and prescribe appropriate interventions. Let’s take a closer look on how to asses and distinguish between ADHD and major depressive disorder (MDD).

Characteristics of ADHD and MDD

When you assess a child patient for ADHD remember to overlap criteria and characteristics and distinguish these diagnoses. Symptoms of mental health conditions are sometimes characterized in terms of changes in self-esteem, pleasure, attention, hyperactivity, sleep, speech, impulsivity, psychomotor activity, and social and academic performance.

Patient Health Questionnaire

MDD screening tests are valuable, but it is important to understand that results of any depression screening alone are inadequate. The US Preventive Services Task Force recommends MDD screening for children ages 12 and older. The Patient Health Questionnaire (PHQ)-2 is a self-administered version of the PRIME-MD diagnostic tool for common mental disorders. There is also a longer PHQ-9 that is the most common tool used to monitor the severity of depression and response to treatmenti. It is available in Spanish, and has a modified version for adolescents .

ADHD Clinical Practice Guidelines

Always refer to clinical practice guidelines for ADHD , and if you do diagnose and treat for ADHD with medications, please make sure to schedule an in-person visit within 30 days of the member starting those medications.

Additional learning tools:

• Quality improvement tools
• Criteria for diagnosing ADHD per DSM-5 and by the American Academy of Pediatrics
• Guidance for Diagnosing MDD
• US Preventive Services Task Force
• PHQ-9
• Screening for MDD is available for adolescents with the modified version

Need help?

Magellan Behavioral Healthcare manages services related to mental and behavioral healthcare. Medicaid providers can call 1-800-327-7390. You can also view the Behavioral Health Toolkit for additional info.

© 2020 American Academy of Pediatrics

The information in this document is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are instructed to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. Regardless of any benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. Additional limitations and requirements may apply.

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