From the Guidelines
The DSM-5 criteria for ADHD require a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, with at least 5 symptoms for adults and 6 symptoms for children under 17, present for at least 6 months, as outlined in the most recent study 1.
Key Criteria
The criteria for ADHD include:
- An ongoing pattern of inattentive and/or hyperactive-impulsive symptoms for at least 6 months
- Multiple inattentive and/or hyperactive-impulsive symptoms, with 5 or more symptoms required for adults and 6 or more for children under 17
- Symptoms must have an onset before the age of 12
- Symptoms must be present in 2 or more settings, such as home, work, or school
- Evidence that symptoms interfere with or reduce the quality of functioning, such as interpersonal or occupational functioning
Inattention Symptoms
Inattention symptoms include:
- Poor attention to detail
- Difficulty concentrating or sustaining attention on tasks
- Difficulty organizing tasks
- Avoiding tasks requiring sustained mental effort
- Losing necessary items
- Being easily distracted
- Forgetfulness
Hyperactivity-Impulsivity Symptoms
Hyperactivity-impulsivity symptoms include:
- Fidgeting
- Leaving seat inappropriately
- Running or climbing excessively (or restlessness in adults)
- Difficulty engaging in leisure activities quietly
- Being "on the go"
- Talking excessively
- Blurting out answers
- Difficulty waiting turn
- Interrupting others
Diagnosis and Specification
ADHD is specified as predominantly inattentive, predominantly hyperactive-impulsive, or combined presentation, with severity rated as mild, moderate, or severe based on symptom count and functional impairment, as noted in the study 1.
Clinical Evaluation
The clinical evaluation for ADHD should include a comprehensive assessment of symptoms and impairment in multiple settings, as well as ruling out alternative causes, as recommended in the study 1 and 1.
From the Research
DSM-5 Criteria for ADHD
The DSM-5 criteria for Attention Deficit Hyperactivity Disorder (ADHD) require the presence of fewer symptoms to make a diagnosis of adult ADHD, while the criteria for diagnosis in childhood are unchanged compared to previous editions 2.
Key Changes in DSM-5
- The new DSM-5 requires the presence of fewer current symptoms for a diagnosis of ADHD, with a significant increase (65%) in the number of participants meeting the new cutoff as compared to the old DSM-IV symptoms cutoff 2.
- The DSM-5 added 4 new symptoms to the hyperactivity and impulsivity aspect, which supports the loading of two factors including inattentiveness and hyperactivity/impulsivity 3.
Diagnostic Criteria
- The diagnostic criteria for ADHD specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C) 4.
- The DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled 4.
Symptoms and Subtypes
- The distinction between inattention and hyperactivity-impulsivity symptoms has concurrent, predictive, and discriminant validity 4.
- The DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response 4.
- Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment 4.