If you suspect that concentration, organisation or inner restlessness has played a role since childhood, you may wonder how an assessment works as an adult. This guide describes the steps that the S3 guideline on ADHD provides for diagnosis, from the first appointment to the result.
Short answer: According to the S3 guideline, assessing ADHD in adulthood relies mainly on a clinical interview, the developmental history and reports from people who know you in daily life. Questionnaires can supplement the picture, but psychological testing and laboratory values alone are not enough. Diagnoses are made by specialists or by psychotherapists for adults. Self-tests do not replace the assessment (Last updated: November 2026).
The most important points in brief
- The assessment should be carried out by specialists or by psychotherapists who treat adults.
- The basis is mainly a clinical interview, supplemented by information from close relatives or other close contacts.
- Development in childhood is examined, even when the complaints only become noticeable in adulthood.
- Questionnaires can be used as a supplement. Psychological testing must not carry the diagnosis alone.
- Laboratory and imaging procedures serve to rule out other causes and do not establish the diagnosis.
Who makes the ADHD diagnosis in adulthood?
The guideline recommends an assessment by specialists in psychiatry and psychotherapy, neurology, psychosomatic medicine or nervous system medicine. Medical or psychological psychotherapists for adults are also suitable. What matters is that the person has experience with adults and with differential diagnosis.
| Involved party | Role in the assessment | Note |
|---|---|---|
| Specialists (psychiatry, neurology, psychosomatics, nervous system medicine) | Clinical assessment and diagnosis | Diagnosis according to the guideline criteria |
| Psychotherapists for adults | Clinical interview, diagnostics and result | Medical or psychological |
| Close contacts | Assessment from everyday life | Only with your consent |
A service can also connect you with other specialists. The right choice depends on where you live and on availability.
How does the assessment run from the first appointment to the result?
The guideline describes building blocks rather than a rigid sequence. In practice they usually follow this order.
- First conversation on history: the onset and course of the complaints, current strain, family history and other illnesses are recorded.
- Clinical interview: the diagnosis rests mainly on this conversation, in which symptoms and impairments are asked about precisely.
- Assessment by others: people who have seen you enough in daily life are asked, for example from family, friends or university.
- Supplementary procedures: questionnaires for self and external assessment, and where appropriate psychological testing and behaviour observation.
- Differentiation: other causes such as depression, anxiety disorders, sleep disorders, substance use or physical illness are excluded.
- Result: the diagnosis follows the criteria of ICD-10 or DSM-5 and requires at least moderate impairment in several areas of life.
Depending on the practice, the process can extend over several appointments. At the first contact, ask which steps are planned and how long they take.
Why does childhood matter?
The guideline provides that, where symptoms first appear in adulthood, it is checked whether subsyndromal symptoms were present in childhood. This sounds technical but is close to everyday life: the question is how you managed at school, at home and among friends as a child. School reports, old notebooks or statements from family can help you remember.
These details matter because concentration problems in studies can have many causes. The course over the years helps the specialist place the cause in context.
Which information should you prepare?
You do not have to compile a complete file before the appointment. A short overview still makes the conversation easier. It can contain the following points:
- The onset and course of the difficulties, for example when learning, keeping appointments or managing a household.
- Situations in which the problems are especially strong, and situations in which they hardly occur.
- Earlier diagnoses, treatments or medication, including from childhood.
- The name of a person who knows you well and would be willing to give an external assessment.
The external assessment is an important building block. Speak to that person beforehand, ask whether they are willing to take part, and clarify what should be discussed.
What is not a route to diagnosis?
The internet offers many self-tests. They can provide orientation, but they do not replace an assessment. The guideline treats self-assessment as part of the interview and the questionnaires, not as a standalone diagnostic procedure. Blood values or imaging cannot prove ADHD either; they only help rule out other causes.
A test result on its own is not enough. Psychological testing can be considered, but the diagnosis must not rest on it alone. If someone offers you a diagnosis based only on an online test, treat that as a warning sign.
What happens after the result?
A result is the start of planning, not the end point. It can be the basis for treatment, for support in your studies or for conversations with your university. Which steps suit you is discussed with the specialist. Compensation for disadvantage is one possible route, described in ADHD in studies: compensation for disadvantage and counselling.
If medication plays a role, availability can fluctuate. The article ADHD medication: supply shortages and what those affected can do (in German) explains the situation and the options.
Frequently asked questions
Can I confirm the ADHD diagnosis myself?
No. A self-assessment helps with orientation, but a specialist makes the diagnosis. The guideline does not provide self-tests as a standalone procedure.
Do I need blood tests or a brain scan?
Laboratory and imaging procedures serve to rule out other causes. They do not prove ADHD. Whether they make sense in your case is decided by the specialist.
How long does the assessment take?
That depends on the number of conversations and supplementary procedures. The guideline gives no fixed duration. Ask at the first contact about the planned course.
Does the diagnosis still count if I was never noticed earlier?
The guideline examines exactly this question. Where symptoms first appear in adulthood, the assessment checks whether childhood symptoms were present that did not reach the full threshold. The specialist decides the outcome in the individual case.
What if ADHD looks different in women?
Symptoms can differ and are often recognised late. The article ADHD in adult women: typical signs and assessment covers this.
What does it mean if the assessment finds no ADHD?
Then the specialist clarifies which other cause is in the foreground, for example a stressful situation or another mental illness. Such a result is also a finding and helps plan the next step. You can ask in the conversation how the results are documented and which recommendations follow.
Why ruling out other causes matters
Concentration problems, restlessness and exhaustion can have many causes. A depressive phase, an anxiety disorder, sleep problems or regular substance use can look similar. For that reason, ruling out other causes is a firm part of the assessment. It protects against assuming ADHD where another cause is in the foreground, and the other way round.
Physical illnesses are also considered, for example thyroid disorders or sleep disorders with a physical cause. The specialist chooses the investigations according to your situation. Laboratory values are a tool in this process, not a diagnosis.
What to do next
- Note the onset, course and everyday effects of your difficulties.
- Arrange an appointment with a specialist or a psychotherapist.
- Ask about the planned assessment steps and whether an external assessment is intended.
Related reading
- Mental health at university: where to find help
- Finding a psychotherapist
- ADHD in adult women: typical signs and assessment
- ADHD in studies: compensation for disadvantage and counselling
- Rising ADHD diagnoses in adults: what lies behind them (in German)
Sources: S3 guideline on ADHD in children, adolescents and adults, AWMF register 028-045 (excerpt, DGPPN) (in German). The statements rest on this excerpt. Which version is currently valid is shown in the AWMF guideline register under registration number 028-045.
Last updated: November 2026. This guide is general information, not individual advice.
