What is ADHD?
ADHD is a neurodevelopmental disorder affecting both children and adults. It is described as a persistent or ongoing pattern of inattention and/or hyperactivity-impulsivity that gets in the way of daily life or typical development. Individuals with ADHD may also have difficulties with maintaining attention, executive function (or the brain’s ability to begin an activity, organize itself and manage tasks) and working memory.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), is the guide that lays out the criteria to be used by doctors, mental health professionals and other qualified clinicians when making a diagnosis of ADHD. The most recent edition of the manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), was released in 2013 and included changes to the definition of ADHD that affect how the disorder is diagnosed in children and in adults.
What about the diagnosis of ADHD has changed with the DSM-5?
What are the DSM-5 criteria for diagnosing ADHD?
As with any DSM-5 diagnoses, it is essential to first rule out other conditions that may be the true cause of the symptoms. Because everyone shows signs of these behaviors at one time or another, the guidelines for determining whether a person has ADHD are very specific. In children and teenagers, the symptoms must be more frequent or severe compared to other children the same age. In adults, the symptoms must affect the ability to function in daily life and persist from adolescence. In addition, the behaviors must create significant difficulty in at least two areas of life, such as home, social settings, school or work. Symptoms must be present for at least six months.
The DSM-5 identifies three presentations of ADHD, depending on the presence or absence of particular symptoms. To be diagnosed with ADHD, children must have six or more of the nine characteristics and older teens or adults must have at least five of the nine characteristics in either or both of the DSM-5 categories listed below.
Do I need to diagnose the severity of symptoms?
As ADHD symptoms affect each person to varying degrees, the DSM-5 requires professionals who diagnose the condition to specify the severity of the disorder in the affected individual. Clinicians can designate the severity of ADHD presentation based on the DSM-5 criterion:
It is also important to note that the severity level and presentation of ADHD can change during a person's lifetime. This includes the possibility that ADHD can go in to partial remission. For this to happen, an individual who previously met all the criteria for a diagnosis would need to experience less than the original number of symptoms found to be present when they were first diagnosed, during the previous six month period.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Washington, D.C.: American Psychiatric Association.