From the Guidelines
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for Attention Deficit Hyperactivity Disorder (ADHD) include an ongoing pattern of inattentive and/or hyperactive-impulsive symptoms that must be present for at least 6 months, with multiple symptoms required for diagnosis, including at least 5 symptoms of inattention and/or hyperactivity-impulsivity for adults, and 6 symptoms for children under 17 years old, as outlined in the most recent study 1.
Key Diagnostic Criteria
The diagnostic criteria for ADHD, as stated in the DSM-5, include:
- An ongoing pattern of inattentive and/or hyperactive-impulsive symptoms—at least 6 months
- Multiple inattentive and/or hyperactive-impulsive symptoms—5 or more (for age 17 years and older; 6 or more are required for age under 17 years)
- Several inattentive and/or hyperactive-impulsive symptoms with an onset before the age of 12 years
- Several inattentive and/or hyperactive-impulsive symptoms that are present in 2 or more settings (e.g., home, work)
- Evidence that inattentive and/or hyperactive-impulsive symptoms interfere with or reduce the quality of functioning (e.g., interpersonal, occupational)
Inattentive and Hyperactive-Impulsive Symptoms
The symptoms of ADHD can be categorized into two main types: inattentive and hyperactive-impulsive.
- Inattentive symptoms include:
- Poor attention to detail
- Difficulty concentrating or sustaining attention on tasks
- Seems preoccupied, difficulty in shifting focus even when spoken to directly
- Difficulty with completing tasks (gets distracted/side-tracked)
- Organizational challenges (e.g., resulting in chronic lateness—for appointments or deadlines, messiness, disorganized work)
- Reluctance to engage in tasks that require sustained mental effort (e.g., preparing reports, reviewing lengthy papers)
- Difficulty keeping track of personal belongings/items required for task completion
- Easily distracted
- Frequently forgetful
- Hyperactive-impulsive symptoms include:
- Frequent fidgeting (e.g., tapping a desk)
- Finds it difficult to sit still for prolonged periods
- Feeling of inner restlessness or agitation
- Often loud and disruptive
- Always on the go, difficult for others to keep up
- Often talks excessively
- Frequently interrupts others (difficulty restraining themselves from sharing their perspectives or waiting their turn in conversation)
- Highly impatient (e.g., difficulty waiting in line)
- Often intrudes into others’ activities (e.g., may take over what others are doing)
ADHD Subtypes
ADHD can be categorized into three subtypes:
- Predominantly inattentive type: 5 or more symptoms of inattention for at least 6 months, but less than 5 symptoms of hyperactivity-impulsivity
- Predominantly hyperactive-impulsive type: 5 or more symptoms of hyperactivity-impulsivity for at least 6 months, but less than 5 symptoms of inattention
- Combined type: 5 or more symptoms of inattention AND 5 or more symptoms of hyperactivity-impulsivity for at least 6 months, as noted in the study 1.
From the FDA Drug Label
A diagnosis of ADHD (DSM-IV) implies the presence of hyperactive-impulsive or inattentive symptoms that cause impairment and that were present before age 7 years. The symptoms must be persistent, must be more severe than is typically observed in individuals at a comparable level of development, must cause clinically significant impairment, e.g., in social, academic, or occupational functioning, and must be present in 2 or more settings, e.g., school (or work) and at home. The symptoms must not be better accounted for by another mental disorder. For the Inattentive Type, at least 6 of the following symptoms must have persisted for at least 6 months: lack of attention to details/careless mistakes, lack of sustained attention, poor listener, failure to follow through on tasks, poor organization, avoids tasks requiring sustained mental effort, loses things, easily distracted, forgetful For the Hyperactive-Impulsive Type, at least 6 of the following symptoms must have persisted for at least 6 months: fidgeting/squirming, leaving seat, inappropriate running/climbing, difficulty with quiet activities, “on the go,” excessive talking, blurting answers, can’t wait turn, intrusive. For a Combined Type diagnosis, both inattentive and hyperactive-impulsive criteria must be met.
The DSM-IV criteria for ADHD include:
- Inattentive Type: at least 6 symptoms of inattention (e.g., lack of attention to details, lack of sustained attention) that have persisted for at least 6 months
- Hyperactive-Impulsive Type: at least 6 symptoms of hyperactivity and impulsivity (e.g., fidgeting, excessive talking) that have persisted for at least 6 months
- Combined Type: both inattentive and hyperactive-impulsive criteria must be met These symptoms must cause clinically significant impairment in social, academic, or occupational functioning, and must be present in 2 or more settings 2 2.
From the Research
Diagnostic Criteria for ADHD
The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for Attention Deficit Hyperactivity Disorder (ADHD) include:
- Extreme levels of inattention-disorganization and/or hyperactivity-impulsivity 3
- Impairment in social, academic, or occupational functioning 3
- Symptoms must be present in more than one setting 4
- Revised criteria for ADHD include the oldest age for occurrence of symptoms and a requirement for a certain number of symptoms in those aged 17 and older 4
DSM-5 Criteria
The DSM-5 criteria for ADHD are useful in diagnosing three subtypes of ADHD based on the presence of symptoms described in three domains:
- Inattention
- Hyperactivity
- Impulsivity 5 The DSM-5 also includes new descriptors referencing adolescent and adult symptom manifestations, which can lead to increased reported inattention symptoms in adolescents 6
Changes to DSM-5 Criteria
Changes to the DSM-5 criteria include: