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Table 17-2: Diagnostic Criteria for ADHD

Diagnostic criteria for ADHD
• Symptoms of inattention OR impulsivity/hyperactivity
─ Which have persisted for 6 months
─ Are more frequent and severe than that which is typical for the individuals
level of development
─ Onset must be prior to 7 years of age
─ Cause impairment in 2 or more settings
ƒ Social, academic, or occupational functioning
─ Are not caused by another mental disorder
Inattentive disorder
• 6 or more of the following:
─ Often fails to give close attention to details or makes careless mistakes
─ Often has difficulty sustaining attention
─ Often does not seem to listen when spoken to
─ Often does not follow instructions or fails to finish work/chores
─ Often has difficulty organizing tasks
─ Often avoids or is reluctant to do things which require sustained mental effort
─ Often loses things necessary for tasks
─ Often easily distracted by extraneous stimuli
─ Often forgetful in daily activities
Hyperactivity
• Often fidgets with hands or feet or squirms
• Often leaves seat or gets up in situations where seating is expected
• Often runs around or climbs excessively in situations in which this is inappropriate
─ Adults and adolescents – feelings of restlessness
• Often talks excessively
• Often “on the go” or often acts as if “driven by a motor”
• Often has difficulty playing or engaging in leisure activities quietly
ADHD DSM-IV subtypes
• ADHD predominantly inattentive type
─ Criteria met for inattention but not hyperactivity
• ADHD predominantly hyperactive-impulsive type
─ Criteria met for hyperactive-impulsive type but not for inattention

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• ADHD combined type

─ Criteria met for both
One proposed treatment algorithm
• Inattentive ADHD
─ Low dose stimulants
─ Antidepressants
─ Organizational training
• Hyperactive ADHD
─ Higher dose stimulants
─ Behavioral therapies
─ Other medications used as an adjunct
• Combined-Type ADHD
─ Combination treatments
Adapted from: Arnold, L.E. 2nd edition. 2002. Contemporary Diagnosis and Management of Attention-
Deficit/Hyperactivity Disorder; Handbooks in Healthcare; Newtown, PA.
Side effects of psychostimulants
• Decreased appetite
• Headache
• Abdominal discomfort
• Insomnia
• Irritability
• Flat affect
• Motor tics (in ~ 15-30%)
Adapted from: The American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th
ed. Text Revision. Washington, D.C. 2000.

©2008 Fitzgerald Health Education Associates, Inc. All rights reserved. Reproduction prohibited.