DSM-5­® Diagnostic

Criteria for ADHD in adolescents1

All criteria must be met for a diagnosis of ADHD:

1
Six or more symptoms of inattention and/or ≥6 symptoms of hyperactivity/impulsivity must have persisted for ≥6 months to a degree that is inconsistent with developmental level and negatively impacts directly on social and academic/occupational activities. For older adolescents (≥ 17 years), at least 5 symptoms are required.
2
Several symptoms (inattentive or hyperactivity/impulsive) were present before the age of 12 years.
3
Several symptoms (inattentive or hyperactivity/impulsive) must be present in ≥2 settings (eg, at home, school, or work; with friends or relatives; in other activities).
4
There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
5
Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (eg, mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, or withdrawal).

DSM-5®=Diagnostic and Statistical Manual of Mental Disorders, 5th edition. DSM-5 is a registered trademark of the American Psychiatric Association.


Diagnosis1

Diagnosis should be based on a complete history and evaluation of the patient.


SYMPTOMS OF INATTENTION*

  • Makes careless mistakes/lacks attention to detail
  • Difficulty sustaining attention
  • Exhibits poor listening skills
  • Fails to follow through on tasks and instructions
  • Exhibits poor organization
  • Avoids/dislikes tasks requiring sustained mental effort
  • Loses things necessary for tasks/activities
  • Easily distracted by unrelated stimuli (for older adolescents and adults, may include unrelated thoughts)
  • Is forgetful in daily activities

SYMPTOMS OF HYPERACTIVITY/IMPULSIVITY*

  • Fidgets with or taps hands or feet, squirms in seat
  • Leaves seat in situations when remaining seated is expected
  • Runs or climbs in situations where inappropriate (in adolescents and adults, may be limited to feeling restless)
  • Has difficulty engaging in quiet, leisurely activities
  • Is “on the go” or acts as if “driven by a motor”
  • Talks excessively
  • Interrupts, blurts out answers
  • Has difficulty waiting their turn
  • Interrupts or intrudes on others

*SYMPTOMS MUST OCCUR OFTEN.


ADHD SYMPTOMS OCCUR IN MULTIPLE SETTINGS

ADHD is recognized as a neurodevelopmental disorder that manifests all day and can persist into adulthood. Adolescence is a time of great change for all of us, and for patients with ADHD it is important to consider how symptoms impact multiple aspects of daily life such as home, school, and social settings.1-3

ADHD Symptoms at Home

HOME

  • Often struggles to focus on completing chores (such as cleaning their room)
  • Often interrupts or struggles to focus in conversations with family members
  • Often has difficulty keeping materials and/or belongings in order (such as those needed for school)
ADHD Symptoms at School

SCHOOL

  • Often makes careless mistakes at school; misses details and assignment due dates
  • Often interrupts classmates or intrudes upon what others are doing
ADHD Symptoms in Social Settings

SOCIAL

  • Often talks excessively or butts into conversations
  • Often struggles to focus during social engagements
  • Often does not seem to listen when spoken to directly

The examples above are examples of what certain symptoms may look like in a particular setting. These are not the complete diagnostic criteria. Diagnosis should be based on complete history and evaluation of the patient.

References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.
  2. Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01600.
  3. Howard AL, Strickland N, Murray DW. Progression of impairment in adolescents with ADHD through the transition out of high school: Contributions of parent involvement and college attendance. J Abnorm Psychol. 2016;125(2):233–247.