ADHD IN ADULTS

I am writing this article in an attempt to help answer questions for those who may feel that they may exhibit symptoms indicative to ADHD. I am compelled to offer some facts that were found based on the DSM-5 Diagnostic.

CRITERIA FOR ADHD IN ADULTS

All criteria must be met for a diagnosis of ADHD in adults:

1. Five or more symptoms of inattention and/or ≥5 symptoms of hyperactivity/impulsivity must have persisted for ≥6 months to a degree that is inconsistent with developmental level and negatively impacts directly on social and academic/occupational activities.
2. Several symptoms (inattentive or hyperactivity/impulsive) were present before the age of 12 years.
3. Several symptoms (inattentive or hyperactivity/impulsive) must be present in ≥2 settings (eg, at home, school, or work; with friends or relatives; in other activities).
4. There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
5. Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (eg, mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, or withdrawal).

DSM-5®=Diagnostic and Statistical Manual of Mental Disorders, 5th edition. DSM-5 is a registered trademark of the American Psychiatric Association.

Diagnosis:

Diagnosis should be based on a complete history and evaluation of the patient.

SYMPTOMS OF INATTENTION

1. Makes careless mistakes/lacks attention to detail
2. Difficulty sustaining attention
3. Exhibits poor listening skills
4. Fails to follow through on tasks and instructions
5. Exhibits poor organization
6. Avoids/dislikes tasks requiring sustained mental effort
7. Loses things necessary tor tasks/activities
8. Easily distracted (including unrelated thoughts)
9. Is forgetful in daily activities

SYMPTOMS OF HYPERACTIVITY/IMPULSIVITY

1. Fidgets with or taps hands or feet, squirms in seat
2. Leaves seat in situations when remaining seated is expected
3. Experiences feelings of restlessness
4. Has difficulty engaging in quiet, leisurely activities
5. Is “on the go” or acts as if “driven by a motor”
6. Talks excessively
7. Blurts out answers
8. Has difficulty waiting their turn
9. Interrupts or intrudes on others
10. Symptoms must occur often.

ADHD SYMPTOMS OCCUR IN MULTIPLE SETTINGS

ADHD is recognized as a neurodevelopmental disorder that manifests all day and can persist into adulthood. Adult patients may experience difficulty in multiple aspects of their daily lives such as at home, at work, or in social situations with friends and family.

ADHD at Home

• Often forgets to run errands and struggles to complete basic household chores
• Often interrupts or struggles to focus in conversations with family members
• Often loses things necessary for tasks or activities

ADHD at Work

• Often makes careless mistakes at work; misses details and deadlines
• Often interrupts colleagues in meetings

ADHD in Social Settings

• Often talks excessively or butts into conversations
• Often struggles to focus during social engagements
• Often does not seem to listen when spoken to directly.

The examples above are examples of what certain symptoms may look like in these settings. These are not the complete diagnostic criteria. Diagnosis should be based on complete history and evaluation of the patient.

References:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.

Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01600.

Adler LA, Chua HC. Management of ADHD in adults. J Clin Psychiatry. 2002;63(suppl 12):29-35.