The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) outlines specific criteria for diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD), ADHD  is a neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

DSM-5 Diagnostic Criteria for ADHD

The diagnosis of ADHD requires the presence of inattention and/or hyperactivity-impulsivity symptoms that persist for at least 6 months, are inconsistent with the individual’s developmental level, and negatively impact social, academic, or occupational functioning. The criteria are separated into two categories: Inattention and Hyperactivity-Impulsivity.

A. Inattention

Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts social and academic/occupational activities:

1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
2. Often has difficulty sustaining attention in tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often has difficulty organizing tasks and activities (e.g., messy, disorganized work; poor time management; fails to meet deadlines).
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework, or for older individuals, preparing reports, completing forms).
7. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys).
8. Is often easily distracted by extraneous stimuli (for older adolescents and adults, this may include unrelated thoughts).
9. Is often forgetful in daily activities, such as chores, running errands (for older adolescents and adults, returning calls, paying bills).

B. Hyperactivity and Impulsivity

Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts social and academic/occupational activities:

1. Often fidgets with or taps hands or feet, or squirms in seat.
2. Often leaves seat in situations when remaining seated is expected (e.g., leaves their place in the classroom or in other situations that require sitting).
3. Often runs about or climbs in situations where it is inappropriate (in adolescents or adults, this may manifest as restlessness).
4. Is often unable to play or engage in leisure activities quietly.
5. Is often “on the go”, acting as if “driven by a motor” (e.g., is unable to remain still for extended periods).
6. Often talks excessively.
7. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for a turn in conversation).
8. Often has difficulty waiting their turn (e.g., while waiting in line).
9. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities).

Additional Criteria

C. Symptoms present before age 12:

• Several inattentive or hyperactive-impulsive symptoms must have been present prior to age 12.

D. Symptoms present in two or more settings:

• Symptoms must be present in at least two settings (e.g., at home, school, or work; with friends or relatives; in other activities).

E. Clear evidence that the symptoms interfere:

• There must be clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

F. Symptoms not better explained by another disorder:

• The symptoms should not be better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder). ADHD should not be diagnosed if the symptoms are solely due to schizophrenia or another psychotic disorder.

Specifiers

• Combined presentation: If both inattention and hyperactivity-impulsivity criteria are met for the past 6 months.
• Predominantly inattentive presentation: If only inattention criteria are met for the past 6 months.
• Predominantly hyperactive-impulsive presentation: If only hyperactivity-impulsivity criteria are met for the past 6 months.
• In partial remission: If fewer than the full criteria have been met in the past 6 months, but symptoms still result in impairment.

Severity Levels

• Mild: Few symptoms beyond the required number for diagnosis are present, and symptoms cause minor impairments in social or occupational functioning.
• Moderate: Symptoms or functional impairment are between “mild” and “severe.”
• Severe: Many symptoms beyond those required for diagnosis, or symptoms that cause significant impairment in social, academic, or occupational functioning.

Age-Specific Considerations

• In children, hyperactivity tends to be more noticeable, while in adolescents and adults, inattentive symptoms (such as difficulty organizing and focusing) may be more prominent.

Conclusion

ADHD impacts academic performance, occupational success, and social interactions. Early diagnosis and intervention can significantly improve outcomes.