{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:06:31Z","timestamp":1790057191256,"version":"4.0.1"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"unspecified","delay-in-days":264,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1092852926101175_sec1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Adult ADHD assessments have increased sharply in recent years, yet the diagnostic yield and predictors of confirmed ADHD among assessment-seeking individuals remain insufficiently understood. This study aimed to examine the sociodemographic and clinical characteristics of adults self-referred or referred by clinicians for suspected ADHD, to determine confirmation rates, factors associated with confirmation, and alternative diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852926101175_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted on 232 adults evaluated at a regional ADHD referral center. Assessments included semi-structured clinical interviews and standardized instruments (DIVA, SCID-5, ADHD-RS). Logistic regression was used to examine factors associated with the final clinical ADHD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852926101175_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 64.2% of individuals received an ADHD diagnosis. Compared with non-ADHD participants, those diagnosed with ADHD were more frequently referred by other healthcare professionals and displayed greater academic impairment. They also showed higher rates of mood swings and delayed sleep onset. Childhood inattention emerged as the only DIVA interview score significantly associated with an ADHD diagnosis. Among individuals without ADHD, the most frequent alternative diagnoses were anxiety disorders and depressive disorders, followed by personality disorders, substance use disorders, and bipolar disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1092852926101175_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adult ADHD emerges as a multifactorial condition shaped by clinical and functional factors. The final clinical diagnosis was most strongly associated with structured clinical tools, functional impairments (in the academic domain), emotional-regulation difficulties, and childhood inattention, whereas self-reported and more general factors were less informative. These findings underscore the importance of a developmentally informed and comprehensive assessment approach, given the high prevalence of psychiatric conditions that may mimic ADHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1092852926101175","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:52:17Z","timestamp":1790056337000},"source":"Crossref","is-referenced-by-count":0,"title":["How many suspected adult ADHD cases actually receive the diagnosis? Related factors in an assessment-seeking sample"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2308-9146","authenticated-orcid":false,"given":"Gianluca","family":"Rosso","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"},{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"San Luigi Gonzaga University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Perotti","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Defilippi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Garrone","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maina","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"},{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"San Luigi Gonzaga University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Di Salvo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Turin"},{"id":[{"id":"https:\/\/ror.org\/048tbm396","id-type":"ROR","asserted-by":"publisher"}],"name":"San Luigi Gonzaga University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"S1092852926101175_r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2004.02.006"},{"key":"S1092852926101175_r26","volume-title":"Barkley Adult ADHD Rating Scale\u2013IV (BAARS-IV)","author":"Barkley","year":"2011"},{"key":"S1092852926101175_r5","unstructured":"5. The Ohio State University Wexner Medical Center. Survey finds 25 percent of adults suspect they have undiagnosed ADHD. Published 2024, accessed 30 October 2025. https:\/\/wexnermedical.osu.edu\/mediaroom\/pressreleaselisting\/survey-finds-25-percent-of-adults-suspect-they-have-undiagnosed-adhd"},{"key":"S1092852926101175_r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.10.011"},{"key":"S1092852926101175_r33","doi-asserted-by":"publisher","DOI":"10.1177\/10870547231158572"},{"key":"S1092852926101175_r42","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-10-67"},{"key":"S1092852926101175_r35","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-2442-7"},{"key":"S1092852926101175_r37","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.571101"},{"key":"S1092852926101175_r34","doi-asserted-by":"publisher","DOI":"10.1080\/23279095.2018.1532429"},{"key":"S1092852926101175_r16","doi-asserted-by":"publisher","DOI":"10.1080\/23279095.2021.1943396"},{"key":"S1092852926101175_r24","volume-title":"Structured Clinical Interview for DSM-5 Disorders: Clinician Version (SCID-5-CV)","author":"First","year":"2016"},{"key":"S1092852926101175_r29","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2025.1549028"},{"key":"S1092852926101175_r31","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2013.07.2685"},{"key":"S1092852926101175_r21","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-024-03713-6"},{"key":"S1092852926101175_r22","doi-asserted-by":"publisher","DOI":"10.1080\/08039488.2021.1904287"},{"key":"S1092852926101175_r1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1212625"},{"key":"S1092852926101175_r12","doi-asserted-by":"publisher","DOI":"10.1177\/1087054715625299"},{"key":"S1092852926101175_r14","doi-asserted-by":"publisher","DOI":"10.1177\/1087054707299367"},{"key":"S1092852926101175_r25","volume-title":"Diagnostic Interview for ADHD in Adults","author":"Kooij","year":"2019"},{"key":"S1092852926101175_r19","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201500269"},{"key":"S1092852926101175_r7","doi-asserted-by":"publisher","DOI":"10.1177\/07067437221082854"},{"key":"S1092852926101175_r41","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21050566"},{"key":"S1092852926101175_r6","unstructured":"6. Italian Medicines Agency (AIFA). Analysis of data from the Italian methylphenidate registry (2019\u20132025). Rome, Italy: AIFA; 2025."},{"key":"S1092852926101175_r38","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114447"},{"key":"S1092852926101175_r40","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1463-3"},{"key":"S1092852926101175_r36","doi-asserted-by":"publisher","DOI":"10.1177\/10870547241284477"},{"key":"S1092852926101175_r3","doi-asserted-by":"publisher","DOI":"10.3390\/ijms262211020"},{"key":"S1092852926101175_r2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)33004-1"},{"key":"S1092852926101175_r9","doi-asserted-by":"publisher","DOI":"10.1177\/1087054709356163"},{"key":"S1092852926101175_r23","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12364"},{"key":"S1092852926101175_r27","volume-title":"ADHD Rating Scale-IV: School Checklist (ADHD-RS-IV)","author":"DuPaul","year":"1998"},{"key":"S1092852926101175_r32","doi-asserted-by":"publisher","DOI":"10.1016\/j.actpsy.2025.105015"},{"key":"S1092852926101175_r10","doi-asserted-by":"publisher","DOI":"10.1177\/1087054711413071"},{"key":"S1092852926101175_r43","doi-asserted-by":"publisher","DOI":"10.1177\/10870547231167564"},{"key":"S1092852926101175_r15","doi-asserted-by":"publisher","DOI":"10.1177\/1087054707310882"},{"key":"S1092852926101175_r4","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21374"},{"key":"S1092852926101175_r30","first-page":"355","article-title":"Survey on centres and procedures for the diagnosis and treatment of adult ADHD in public services in Italy","volume":"55","author":"Zadra","year":"2020","journal-title":"Riv Psichiatr"},{"key":"S1092852926101175_r39","doi-asserted-by":"publisher","DOI":"10.1037\/0012-1649.42.2.350"},{"key":"S1092852926101175_r18","unstructured":"18. Canadian ADHD Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines. Version 4.1. Toronto, ON, Canada: CADDRA; 2020."},{"key":"S1092852926101175_r8","doi-asserted-by":"publisher","DOI":"10.1177\/10870547231172764"},{"key":"S1092852926101175_r17","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-0682-3_13"},{"key":"S1092852926101175_r20","doi-asserted-by":"publisher","DOI":"10.1002\/pcn5.70024"},{"key":"S1092852926101175_r11","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000248"}],"container-title":["CNS Spectrums"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1092852926101175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:52:19Z","timestamp":1790056339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1092852926101175\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1092852926101175"],"URL":"https:\/\/doi.org\/10.1017\/s1092852926101175","relation":{},"ISSN":["1092-8529","2165-6509"],"issn-type":[{"value":"1092-8529","type":"print"},{"value":"2165-6509","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e39"}}