Thursday, Oct. 19
15:45 – 16:45 (1 hr)
Meeting Room: Finback (3rd floor – B Tower)
Elisabeth Baerg Hall*, MD, CCFP, FRCPC,; Elisabeth Baerg Hall, MD,CCFP, FRCPC; Doron Almagor, MD FRCPC

CanMEDS Roles:

1. Professional
2. Health Advocate
3. Medical Expert

At the end of this session, participants will be able to: 1) Identify diagnostic features in adult attention-deficit hyperactivity disorder (ADHD) and related neurodevelopmental comorbidities, such as autism spectrum disorder; 2) Evaluate factors that contribute to delayed diagnosis of neurodevelopmental disorders in adults who are intelligent, hardworking, and persistent; and 3) Consider challenges faced by physicians with ADHD and offer practical strategies for supporting executive function skills and patient care.

Despite advances in the science of attention-deficit hyperactivity disorder (ADHD) and its comorbidities, biases and misunderstandings prevail, causing needless suffering and potential harm. The science is clear: more people with high intelligence are diagnosed with ADHD and comorbidities like autism spectrum disorder (ASD) later in life than those with average or lower IQ. High intelligence paired with high persistence can further obscure diagnostic clarity.
Success in the medical profession requires high intelligence and impressive grit. Work is unrelenting, with never catching up feeling common and difficult patient exchanges happening to everyone at times. In this context of shared expectations, smart, hard-working physicians are at high risk for remaining undiagnosed and untreated when their own neurodevelopmental differences exist, making a tough job even harder. Astute diagnosticians may also fail to recognize challenges in themselves given limited insight consistent with disorders that compromise frontal lobe functioning. New diagnoses can bring new challenges as well. Physicians may feel perplexed by their inability to function at expected levels, leading to potential shame, doubt, anxiety, or depression in the wake of unexpected news delivered later in life.
In this workshop, we’ll use video segments, discussion, and didactic case-based approaches to review key diagnostic features of ADHD and ASD. We’ll provide a practical lens for diagnosing neurodevelopmental disorders in adults and discuss diagnostic and treatment approaches for physicians challenged by these conditions. We’ll also share practical strategies and preliminary data from a British Columbia initiative for supporting executive function skills in physicians with ADHD and related comorbidities.

References:

1. Milioni AL, Chaim TM, Cavallet M, et al. High IQ may “mask” the diagnosis of ADHD by compensating for deficits in executive functions in treatment-naïve adults with ADHD. J Atten Disord 2017;21(6):455–464.
2. Baggio S, Hasler R, Deiber MP, et al. Associations of executive and functional outcomes with full-score intellectual quotient among ADHD adults. Psychiatr Res 2020;294:113521.