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Use of DIVA-5 ID

The Diagnostic Interview for ADHD in Adults with Intellectual Disability (DIVA-5-ID)

The DIVA is based on the DSM-5 criteria for ADHD and is the third edition of the first structured Diagnostic Interview for ADHD in adults (DIVA). The DIVA-5 is the successor of the DIVA 2.0 that was based on the previous DSM-IV-TR criteria.

In order to simplify the evaluation of each of the 18 symptom criteria for ADHD, in childhood and adulthood, the interview provides a list of concrete and real life examples, for both current and retrospective (childhood) behaviour in people with ID. The examples are based on the common descriptions provided by adult patients with ID and their carers in clinical practice. Examples are also provided of the types of impairments that are commonly associated with the symptoms in five areas of everyday life: work and education; relationships and family life; social contacts; free time / hobbies; self-confidence / self-image. Whenever possible the DIVA should be  completed with adults with ID and their carers to enable retrospective and collateral information to be ascertained at the same time. The DIVA in people with non ID usually takes around one and a half hours to complete. This can take longer in people with ID.

The DIVA only asks about the core symptoms of ADHD required to make the DSM-5 diagnosis of ADHD, and does not ask about other co-occurring psychiatric symptoms, syndromes or disorders. However comorbidity is commonly seen in both children and adults with ADHD, in around 75% of cases. For this reason, it is important to complete a general psychiatric assessment to enquire about commonly co-occurring symptoms, syndromes and disorders. The most common mental health problems that accompany ADHD include anxiety, depression, bipolar disorder, substance abuse disorders and addiction, sleep problems and personality disorders, and all these should be investigated. This is needed to understand the full range of symptoms experienced by the individual   with ADHD; and also for the differential diagnosis, to exclude other major psychiatric disorders as the primary cause of ‘ADHD symptoms’ in adults.