Diagnosis
DSM-IV diagnostic criteria
Many individuals with ADHD have symptoms of both hyperactivity–impulsivity and inattention, although one subtype may predominate.1 All symptoms must be inconsistent with the patient’s developmental level and intellectual ability, and have been present for a minimum of 6 months.
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For a predominantly hyperactive–impulsive type diagnosis, the individual must have exhibited at least six symptoms of hyperactivity–impulsivity, but fewer than six symptoms of inattention.
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For a predominantly inattentive type of ADHD, the individual must have six or more symptoms of inattention, but fewer than six symptoms of hyperactivity–impulsivity.
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The combined type is diagnosed when a minimum of six symptoms each of inattention and hyperactivity–impulsivity are present.
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Some individuals may exhibit some of the symptoms of ADHD, but do not meet the full criteria for any of the subtypes. These children are diagnosed as ‘ADHD not otherwise specified’.
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Those whose symptoms partially resolve and who therefore no longer meet the full diagnostic criteria are categorized as being in partial remission.1
Onset of ADHD symptoms occurs in young children, and DSM-IV diagnostic criteria specify the presence of symptoms before the age of 7 years. Evidence of functional impairment within two or more settings is also required, with behaviour adversely affecting the individual’s functioning in an academic or social setting. Finally, the symptoms should not occur exclusively during a pervasive developmental disorder or psychotic condition, and they should not be better accounted for by other mental health conditions.
Reference:
1. American Psychiatric Association. Attention-deficit and disruptive behavior disorders. Attention-deficit/hyperactivity disorder. In: Diagnostic and statistical manual of mental disorders. 2000, American Psychiatric Association. 85–103.