ADHD diagnosis criteria

Diagnostic and Statistical Manual of Mental Disorders on ADHD

In the USA these criteria are laid down by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edition, the next revision DSM V, is due in 2012. UK psychiatrists use this along with the NICE guidelines on ADHD and other list criteria (such as the WHO list) and a personal history for diagnosis.

DSM V – ADHD Diagnostic Criteria

According to the APA, many of the symptoms of ADHD occur from time to time in everyone; in people with ADHD, the frequency of these symptoms is greater and significantly impairs their life. This impairment must occur in multiple settings to be classified as ADHD. In the DSM-IV criteria listed below, three types of ADHD are classified:

• ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months
• ADHD Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months
• ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months

The previously used term ADD expired with the most recent revision of the DSM. Consequently, ADHD is the current nomenclature used to describe the disorder as one distinct disorder which can manifest itself as being a primary deficit resulting in hyperactivity/impulsivity (ADHD, predominately hyperactive-impulsive type) or inattention (ADHD predominately inattentive type) or both (ADHD combined type).

DSM-IV criteria

I. Either A or B:

A – Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:

Inattentive

• Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
• Often has trouble keeping attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
• Often has trouble organizing activities.
• Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
• Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
• Is often easily distracted.
• Often forgetful in daily activities.

B – Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

Hyperactivity:

• Often fidgets with hands or feet or squirms in seat
• Often gets up from seat when remaining in seat is expectedv
  
• Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless)
• Often has trouble playing or enjoying leisure activities quietly
• Is often “on the go” or often acts as if “driven by a motor”
• Often talks excessively

Impulsiveness

• Often blurts out answers before questions have been finished
• Often has trouble waiting one’s turn
• Often interrupts or intrudes on others (e.g., butts into conversations or games).

II. Some symptoms that cause impairment were present before age 7 years

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home)

IV. There must be clear evidence of significant impairment in social, school, or work functioning

V.  The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder)