Varied presentations of undiagnosed ADHD in adolescents: A case series

ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) in adolescents often presents with atypical symptoms and high psychiatric comorbidity, leading to misdiagnosis or delayed identification. This case series describes five diverse clinical presentations of ADHD, including somatic complaints, behavioural disturbances, functional neurological symptoms, mood dysregulation, and excessive technology use. Each case highlights how core ADHD symptoms—particularly inattention, impulsivity, and emotional dysregulation were initially obscured by anxiety, depression, conduct symptoms, or somatization, causing misdiagnoses and delayed effective intervention. However, once ADHD was correctly identified and managed through psychoeducation, behavioral strategies, and pharmacotherapy, significant improvements were observed in academic performance, emotional functioning, and social engagement. This series underscores the need for comprehensive, developmentally informed assessments in adolescents, along with broad differential diagnoses when faced with nontraditional symptom profiles. Early recognition and multimodal treatment of ADHD can prevent long-term adverse outcomes and improve overall functioning.