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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 2002 March;43(1):57-62
Hyperactivity in child abuse and differential diagnosis with ADHD. A case study
Donfrancesco R., Pinzauti S.
ADHD diagnosis is now more frequent in Italian clinics. Consequently, an accurate differential diagnosis is very important. International literature has pointed out the possible misdiagnosis with PTSD, especially relative to sexual abuse. Many abused children has been reported to present PTSD (44.4 %) and ADHD symptoms (33.3%). The aim of this study is to underscore the differences between these two pathologies, by presenting a representative clinical case. A girl, victim of a continued abuse from age 5 to 12, received a diagnosis of ADHD at age 7. An assessment performed at age 12, three months after the revelation of the abuse, was compared with the initial assessment (age 7) and with an observation fulfilled three months before the revelation of the abuse. PTSD subscale of CBCL shows an elevated score (>2 SD) before and after the abuse revelation. On the contrary, ADHD Rating Scale and Conner's Teacher Rating Scale shows a rapid decrement of the total scores after the abuse revelation, determining the exclusion of an ADHD diagnosis. The CBCL and the CDI scores confirm the rapid change from an externalizing symptomatology to an internalizing symptomatology. Therefore the correct diagnosis was PTSD and not ADHD. Some indications to avoid this type of clinical mistake are formulated in the conclusions.