ADHD and DSM-V diagnostic criteria
ADHD is one of the most frequent mental disorders among children and adolescents. Recently, the American Psychiatric Association has published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-V (American Psychiatric Association, 2013). The diagnostic criteria on this manual are the most widely used among professionals in mental health all around the world to diagnose mental disorders.
ADHD subtypes no longer exist as used in DSM-IV-TR and are reconceptualized in DSM-V as ADHD presentation types. Nevertheless, they have the same nomenclature (Inattentive, Hyperactive-Impulsive or Combined) and the same intention (that is, to reflect the most prevalent symptoms on patient), although they do not reflect a different ADHD diagnostic category.
- Inattentive presentation is more common in girls (30%) whereas in boys is 15%. The inattentive ONLY present inattention symptoms. They have problems for not paying attention, they forget what they have just told you five minutes ago, difficulties to follow instructions, frequently lose things (clothes, keys…). Attentional problems may be associated with anxiety disorders. Academic achievement can be good, and usually there are no conduct problems neither at school nor at home. Because of this, diagnostic of ADHD attentional presentation can be more difficult. To be diagnosed, it is necessary that symptoms have persisted for al least 6 months. Symptoms are the same than those in DSM-IV-TR, but with some adaptations for young adolescents (over 17) and adults.
- Hyperactive-Impulsive presentations have hyperactivity and impulsive symptoms, without inattention symptomatology. They are children that act as if “driven by a motor”, always running and moving even sitting. Often interrupts or intrudes in other people’s conversations, are unable to play (or work) in activities quietly. To be diagnosed, it is necessary that symptoms have persisted for al least 6 months. Symptoms are the same than those in DSM-IV-TR, but with some adaptations for young adolescents (over 17) and adults.
- Combined presentation is the most common both in boys (80%) and in gilrs (60%), and they present inattention, hiperactivity and impulsive symptoms.
- The minimum age to diagnose ADHD goes from 7 to 12 years. That is, to diagnose a patient with ADHD, he has to present symptoms prior the age of 12.
- For older adolescents and adults (age 17 and older) at least five symptoms are required to make the diagnosis.
- As in DSM-IV-TR, symptoms has to be present in two or more settings (home, school, work, community…) and those symptoms have to cause functional impairment on patients life.
American Psychiatric Association (2013). American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA.