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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)

Andrew Lewis

Andrew Lewis is an ADHD Coach, writer and founder of SimplyWellbeing. He has over 15,000 hours and 18 years of experience in coaching over 500 ADHD executives, ADHD business professionals and ADHD creatives. Andrew ran a major ADHD support group and an ADHD diagnostic clinic for a while. He is an ADHD specialist backed with business expertise from a twenty years career in software, from roles in programming, through marketing, sales and to running a few software start-ups. His ADHD insight is personal, with decades understanding his own ADHD experience and in bringing up his ADHD daughter. He has published his writing primarily via this website, with interactive ADHD courses in development.