Guide · Adult ADHD
Adult ADHD Diagnosis: Process, Tests & Cost
Most adults considering ADHD have years of self-doubt behind them. This guide explains in plain language how a guideline-compliant adult ADHD assessment works, which tests are used and how long it takes.
1. When is an ADHD assessment useful?
In adults, ADHD rarely looks like "hyperactive kid" behaviour. It typically shows as long-standing concentration problems, inner restlessness, chronic procrastination, emotional dysregulation, sensory overload, sleep problems, or a cycle between hyperfocus and exhaustion. Many people describe "functioning at double the energy cost", and later develop depression, anxiety or burnout as comorbid conditions.
A specialist assessment is warranted when these symptoms started in childhood, affect several life areas (work, relationships, household), and cannot be better explained by another condition.
2. The 4-step process
- 1
Initial consultation (50 min)
Your concern, current symptoms, life story, level of distress and previous treatments. We clarify whether a full assessment is indicated and how it will unfold.
- 2
Structured testing (90 to 180 min)
Standardised interviews and questionnaires (see section 3), self-report and — where possible — third-party history (partner, parents, school reports).
- 3
Differential diagnosis & medical workup
Distinguishing from anxiety, depression, bipolar disorder, PTSD, autism spectrum, sleep and thyroid disorders. Lab tests recommended where indicated.
- 4
Feedback session & written report (30 to 50 min)
Diagnosis disclosure, individual treatment recommendation (psychotherapy, coaching, possibly medication) and a written report for you, your GP or therapist.
3. Which tests are used?
DIVA-5
Diagnostic Interview for ADHD in Adults — the international gold standard. Structured assessment of all 18 DSM-5 criteria in adulthood and childhood.
CAARS
Conners' Adult ADHD Rating Scales, self- and observer form. Quantifies symptom severity across four factors (inattention, hyperactivity, impulsivity, self-concept).
WURS-K
Wender Utah Rating Scale (short form): retrospective assessment of childhood ADHD symptoms, essential because ADHD by definition begins before age 12.
Comorbidity screening
BDI-II (depression), GAD-7 (anxiety), AUDIT (alcohol), AQ-10 (autism spectrum) and sleep history — to capture common co-occurring conditions.
4. Differential diagnosis: what else it could be
Many other conditions produce ADHD-like symptoms. A rigorous assessment systematically checks alternatives and either rules them out or recognises them as comorbidities.
- Depression: concentration problems and loss of drive, usually episodic.
- Anxiety and panic disorders: inner restlessness, avoidance, physical tension.
- Bipolar disorder: hypomanic phases can look like ADHD but respond differently to stimulants.
- PTSD & complex trauma: concentration and sleep issues, emotional dysregulation.
- Autism spectrum: sensory overload and executive difficulties, frequently comorbid with ADHD.
- Thyroid, sleep, iron metabolism disorders: fatigue and attention deficits.
5. Duration
Time investment
About 3.5 to 4 hours in total — either as a single block on request or spread over 3 to 4 sessions. Written report after the feedback session.
Structure
Initial consultation, structured diagnostics with validated instruments, differential diagnosis and feedback session with treatment recommendation.
6. What happens after the diagnosis?
An ADHD diagnosis is not the end but the start of a targeted treatment plan. The German S3 ADHD guideline recommends a multimodal approach:
- Psychoeducation: understanding how your mind works — often the most effective first step.
- Psychotherapy: ADHD-specific CBT, mindfulness, self-regulation strategies.
- Medication: methylphenidate, lisdexamfetamine or atomoxetine — carefully titrated when indicated.
- Coaching & environmental adjustment: structure at home, work, relationships.
- Treatment of comorbidities: depression, anxiety, addiction, sleep disorders.
7. FAQs
Is an online test enough for an ADHD diagnosis?
No. Online tests can suggest suspicion but never replace a specialist assessment. A valid diagnosis requires structured interviews, third-party history and differential diagnosis.
Can you have ADHD without hyperactivity?
Yes. The predominantly inattentive presentation is especially common in women and is often only recognised in adulthood.
What should I bring to the first appointment?
If available: old school reports, previous medical letters, medication list, and notes on example situations from childhood and current life. A close relative or partner for third-party history is helpful but not mandatory.
Will the diagnosis show up for insurers or employers?
No. Private diagnoses are not shared with employers or authorities. If you plan to take out disability or life insurance, we recommend getting individual advice first.
How quickly can I get an appointment?
At the private practice of Doctor-medic Otilia Gudana first appointments are usually available within 5 to 6 business days, in person in Munich.
Request an ADHD assessment
Guideline-compliant, specialist, with time for your story. First appointment usually within 5 to 6 business days.