Here you will find:
1. Current Diagnostic Criteria
2. Future Diagnostic Considerations
3. Conditions that Mimic or Co-Occur with ADHD
The term “Attention-Deficit Hyperactivity Disorder” is used to capture a broad range of disorders that may differ significantly in terms of presentation, genetics, causes, and response to treatment. The American Psychiatric Association last published diagnostic criteria for ADHD in 2000 (Diagnostic & Statistical Manual-IV-TR), but there was no change in the criteria from the previous publication in 1994. There are limitations of the DSM-IV TR diagnostic formulation, and specialists anticipate considerable revisions when the DSM is published again. Publication of the DSM-V is currently projected for 2011. The DSM-V committee will be meeting in 2007 to evaluate the current diagnostic criteria and relevant research.
Current Diagnostic Criteria
The DSM-IV-TR diagnostic criteria focus on ADHD as a disorder of childhood, so the symptoms are couched in terms applicable to children. This will likely be addressed in the DSM-V.
In brief, the current diagnostic criteria include:
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At least 6 of 9 symptoms of inattention AND/OR
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At least 6 of 9 symptoms of hyperactivity and/or impulsivity
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Presence of symptoms prior to age 7
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Presence of symptoms in at least two different settings (e.g., school and home)
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Clear evidence of significant impairment in several arenas
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Symptoms cannot be better explained by another medical or psychiatric disorder
Adolescents and adults who no longer meet full criteria may be described as “in partial remission”.
According to the DSM-IV TR, there are three subtypes:
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Attention-Deficit Hyperactivity Disorder, Combined Type
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Attention-Deficit Hyperactivity Disorder, Predominantly Inattentive Type
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Attention-Deficit Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
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Future Diagnostic Considerations
The DSM-V is expected to address a variety of diagnostic issues that are currently being debated among ADHD specialists. In particular, it is anticipated that the DSM-V will expand and clarify the diagnostic criteria by setting clear guidelines for diagnosing adults as well as addressing age of onset. The DSM-V is also likely to layout expanded guidelines for subtypes, possibly adding to the current three subtypes mentioned above. It is also expected to give more assistance in making distinctions between ADHD and other disorders that can mimic ADHD but are really distinct (e.g., mood disorders, anxiety disorders).
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CONDITIONS that Mimic or Co-occur with ADHD
Some disorders that can be mistaken for ADHD include:
- Sleep Disorders
- Seizure Disorders
- Thyroid Disorders
- Head Injury
- Substance Abuse/Dependence
- Thought Disorders
- Mood Disorders
- Anxiety Disorders
- Obsessive Compulsive Disorder
Some disorders that may co-occur with ADHD include:
- Mood Disorders (e.g., depression; bipolar)
- Anxiety Disorders
- Learning Disabilities
- Asperger’s and Autism
- Conduct Disorder
- Oppositional Defiant Disorder
- Substance Abuse/Dependence
As you can see, the possibility of missing or misdiagnosing other problems makes the diagnostic process quite complex and requires a clinician who is very familiar with both ADHD and a broad range of other disorders. Clinicians who may be qualified to diagnose ADHD include pediatric and adult neurologists, clinical psychologists, neuropsychologists, and psychiatrists. General practitioners and pediatricians who have sought additional expertise may also be qualified to diagnose. It is strongly recommended that you ask about a clinician’s experience with diagnosing ADHD before deciding to schedule an appointment.
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A final caveat: Despite what you may have heard or read in the popular press, at this time there is no single test of any kind that can definitively identify ADHD. For more details on what is involved in the diagnostic process, click to the Evaluations page.
