From the Guidelines
The World Health Organization (WHO) criteria for ADHD in adults, as per the most recent evidence, require a persistent pattern of inattention and/or hyperactivity-impulsivity that significantly interferes with functioning or development, with at least five symptoms of inattention and/or five symptoms of hyperactivity-impulsivity, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 1. To meet the WHO criteria for ADHD, adults must demonstrate a combination of symptoms, including:
- At least five symptoms of inattention, such as poor attention to detail, difficulty concentrating, or organizational challenges
- At least five symptoms of hyperactivity-impulsivity, such as frequent fidgeting, feeling of inner restlessness, or difficulty waiting turns These symptoms must have been present before age 12, persist for at least six months, occur in multiple settings, and cause significant impairment in social, academic, or occupational functioning 1. The WHO criteria also specify that symptoms cannot be better explained by another mental disorder and must represent a clear change from the person's typical behavior 1. It is essential to note that adult ADHD manifestations may be more subtle, with hyperactivity often presenting as inner restlessness rather than obvious physical activity 1. The diagnosis of ADHD in adults should be based on a comprehensive evaluation, including a thorough medical history, physical examination, and the use of standardized assessment tools, such as the Adult ADHD Self-Report Scale (ASRS-V1.1) 1.
From the Research
WHO Criteria for ADHD in Adults
The World Health Organization (WHO) has developed criteria for the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. According to a study published in 2017 2, the WHO Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5 is a useful tool for screening adults for ADHD. The scale consists of 6 questions and has been shown to have excellent operating characteristics, including a sensitivity of 91.4% and a specificity of 96.0%.
Diagnostic Criteria
The diagnostic criteria for ADHD in adults, as outlined in the DSM-5, include:
- A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or relationships
- At least 5 symptoms of inattention and/or hyperactivity-impulsivity must be present in two or more settings (e.g., home, work, school)
- Symptoms must have been present in some form prior to age 12
- Symptoms must have been present for at least 6 months
- Symptoms must cause significant distress or impairment in social, occupational, or other areas of functioning
Key Findings
Some key findings related to ADHD in adults include:
- A study published in 2010 3 found that almost half of adults with childhood ADHD continued to meet the full DSM-IV criteria for current adult ADHD
- A study published in 2016 4 found that adult ADHD is primarily treated with pharmacotherapy assisted by behavior interventions
- A study published in 2013 5 found that both methylphenidate and atomoxetine improved executive functions in adults with ADHD, with atomoxetine showing greater improvement in spatial planning
Treatment Options
Treatment options for ADHD in adults include:
- Pharmacotherapy, such as methylphenidate and atomoxetine
- Behavior interventions, such as cognitive-behavioral therapy and behavioral modification
- Lifestyle changes, such as regular exercise and a healthy diet
- Education and support, such as counseling and support groups
Important Considerations
Some important considerations when diagnosing and treating ADHD in adults include:
- Comorbidities, such as depression and anxiety, which are common in adults with ADHD
- Medication side effects and interactions
- Lifestyle factors, such as sleep and exercise, which can impact ADHD symptoms
- The need for ongoing monitoring and adjustment of treatment plans as needed