Abstract
Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that is often diagnosed in childhood and can persist into adulthood. This disorder is characterized by inattention, hyperactivity, and impulsivity that significantly interfere with daily functioning. In Quebec, there is a problem of overdiagnosis and overprescription of psychostimulants compared to the usual global statistics. In fact, the diagnosis of attention deficit hyperactivity disorder is normally based on a detailed clinical assessment, including analysis of medical, family, and environmental history, as well as the use of validated rating scales and structured clinical interviews that understand their limitations. However, the differential diagnosis is challenging due to the presence of various comorbidities, such as mood disorders, anxiety disorders, sleep disorders, and learning disabilities. In addition, some modern environmental factors, such as excessive screen exposure, have been associated with symptoms of inattention, agitation, and impulsivity in children. Since secure attachment relationships play a crucial role in a child's development, things like family instability, high parental stress, lack of emotional availability, or inconsistent parenting practices can weaken attachment and lead to “Attention-Deficit-Hyperactivity-Disorder-Like” behaviors. Beyond the clinical issues, it is also an ethical concern to ensure that the therapeutic direction is optimized for the benefit of the patient. This article examines the issues related to the diagnostic process by emphasizing the importance of a comprehensive and integrative assessment that considers environmental and relational factors. Such an approach makes it possible to better distinguish attention deficit hyperactivity disorder from other pathologies and to develop appropriate therapeutic strategies, ranging from conventional pharmacological treatments to interventions focused on managing exposure to screens and strengthening secure attachment bonds. This comprehensive diagnostic framework offers large potential to improve patient care and optimize long-term clinical outcomes.