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ADHD

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in the world and one of the most common disorders of childhood, with a prevalence in school aged children of around 9 to 15 percent.  It is more common in boys than girls (14% boys vs 6% in girls), and in 20-25% of cases it presents with psychiatric comorbidities (e.g. oppositional defiant disorder, anxiety, or depression). A diagnosis is generally made by a clinical interview of parents and kids, but it is preferable to diagnose after information is obtained from multiple settings. If not treated, there is a significant risk in terms of social functioning, school functioning, and occupational functioning.

Diagnosis

ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is present before the age of 12 years, interferes with functioning or development, and is present in more than one setting (e.g. at home, school or work; with relatives or friends; required or leisure activities). A person must have at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity to be diagnosed with ADHD. 

Symptoms of inattention include:

  • Making frequent careless errors or overlooking details
  • Difficulty sustaining attention in tasks/activities
  • Failing to complete tasks/work
  • Difficulty organizing tasks
  • Becoming easily distracted
  • Being forgetful in daily activities
  • Frequently losing important/necessary items
  • Avoiding tasks that require sustained mental effort.

Symptoms of hyperactivity-impulsivity include:

  • High levels of fidgeting
  • Feeling restless
  • Inability to stay in seat when expected
  • Running or climbing at inappropriate times/places
  • Talking excessively
  • Blurting out answers
  • Unable to wait turn
  • Frequently interrupting/intrusive with others.

Widely available scales (see below) are an effective way of obtaining this information from collateral sources. It is necessary during the diagnosis process to also consider medical, psychosocial and developmental issues that could be mistaken for ADHD. It is also very important to obtain family history as it is an extremely heritable disorder. 20-25% of cases have psychiatric comorbidities (e.g. oppositional defiant disorder, anxiety, or depression).

Comparison of DSM-5 and ICD-10 Diagnostic Criteria for ADHD

The table below is excerpted from “Are We Overdiagnosing and Overtreating ADHD?” Click to download a printable PDF of the table.

Rating Scales

(Click to download a printable PDF with more detail on these Ratings Scales)

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