Symptoms and Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, 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 AD/HD. The most recent edition of the manual is the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). The next edition of the manual, DSM-V, is currently being prepared and is expected to be published in May 2012.

As with all DSM-IV diagnoses, it is essential first to rule out other conditions that may be the true cause of symptoms. The DSM-IV identifies three sub-types of AD/HD, depending on the presence or absence of particular symptoms: Inattentive type, Hyperactive type, and Combined type.

Because everyone shows signs of these behaviors at one time or another, the guidelines for determining whether a person has AD/HD are very specific. To be diagnosed with AD/HD, individuals must have six of the nine characteristics in either or both DSM-IV categories listed below.

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 childhood.

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.

Criteria for the three primary subtypes are:

AD/HD - Predominantly Inattentive Type

Fails to give close attention to details or makes careless mistakes.
Has difficulty sustaining attention.
Does not appear to listen.
Struggles to follow through on instructions.
Has difficulty with organization.
Avoids or dislikes tasks requiring sustained mental effort.
Loses things.
Is easily distracted.
Is forgetful in daily activities.

AD/HD - Predominantly Hyperactive/Impulsive Type

Fidgets with hands or feet or squirms in chair.
Has difficulty remaining seated.
Runs about or climbs excessively.
Difficulty engaging in activities quietly.
Acts as if driven by a motor.
Talks excessively.
Blurts out answers before questions have been completed.
Difficulty waiting or taking turns.
Interrupts or intrudes upon others.

AD/HD - Combined Type

Individual meets both sets of inattention and hyperactive/impulsive criteria.