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DSM-5® DIAGNOSTIC CRITERIA

ADHD is characterized by a persistent pattern of inattention and/or
hyperactivity/impulsivity that interferes with functioning or development.1

DSM-5® DIAGNOSTIC CRITERIA FOR ADHD IN ADULTS1

All criteria must be met for a diagnosis of ADHD in adults1:

  • 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 the developmental level and negatively impacts social and academic/occupational activities.
  • Several symptoms (inattentive or hyperactive/impulsive) were present before the age of 12 years.
  • Several symptoms (inattentive or hyperactive/impulsive) must be present in ≥2 settings (eg, at home, school, or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
  • 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).

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

Among other criteria that must be met for a diagnosis of ADHD, several symptoms (inattentive or hyperactive/impulsive) must be present in 2 or more settings (eg, at home, school, or work; with friends or relatives; in other activities).

Symptoms must occur often

SCREENING AND DIAGNOSTIC SCALES FOR USE WITH ADULTS

To aid physicians and psychologists in the diagnostic process, several validated behavior scales have been developed to help screen, diagnose, evaluate, and track symptoms of ADHD in adults.

These scales are not to be used as sole diagnostic tools, nor should they replace the full clinical assessment based on the DSM-5® criteria; however, they may help review and quantify symptoms.2

Common behavior rating scales used in adults to assess ADHD and monitor ADHD symptoms.2-6

ADULT ADHD SELF-REPORT SCALE (ASRS-v1.1)
SYMPTOM CHECKLIST

An 18-item scale that can be used as an initial symptom assessment to identify adults who may have ADHD2-3

  • The scale has a question for each of the 18 symptom domains identified by the DSM-IV® criteria, with modifications to account for the adult presentation of ADHD symptoms
  • Measures the frequency of how often symptoms occur based on a 0 to 4 rating scale (0=never, 1=rarely, 2=sometimes, 3=often, 4=very often)

ADULT ASRS-v1.1 SCREENER

A 6-question subset of the full 18-item ASRS-v1.1 Symptom Checklist that can be used to screen for adults who may have ADHD2-4,6

  • Can be used as an initial self-assessment tool to identify adults who may have ADHD but it is not diagnostic in and of itself
  • The 6-question subset (Part A) of the ASRS Symptom Checklists comprised of questions that were found to be most predictive of ADHD symptoms
  • Scoring is based on how often a symptom occurs

ADULT ADHD CLINICAL DIAGNOSTIC SCALE (ACDS) v1.2

A diagnostic measure developed to establish the presence of current adult symptoms of ADHD5-6

  • The 18-item, clinician-based, semistructured interview employs adult-specific language to ensure adequate probing of adult manifestations of ADHD symptoms
  • The 18 items in the scale correspond to the 18 symptoms in the DSM-IV® criteria

BROWN ATTENTION-DEFICIT DISORDER RATING SCALE (BADDS) FOR ADULTS

A broad-based, 40-item rating scale providing a rating of the frequency of symptoms in many domains3

  • Items represent 5 dimensions of symptoms: organizing work, sustaining attention and concentration, sustaining alertness and effort, managing frustration and other emotions, and using work memory
  • The scale can be used as a self-report or as a clinician-administered scale
  • Scoring is based on a 4-point frequency scale ranging from 0=never to 3=almost daily

ADHD RATING SCALE IV (ADHD-RS-IV) WITH ADULT PROMPTS

An 18-item scale corresponding to the 18 items in the DSM-IV© criteria, providing physicians with a method to rate adults by the frequency and severity of symptoms2-3

  • Contains 9 items assessing inattentive symptoms and 9 items assessing hyperactive/impulsive symptoms
  • Scoring is based on a 4-point Likert-type severity scale ranging from 0=never to 3=very often

QandADHD FACT SHEET

Use the QandADHD Fact Sheet for a deeper look at how your patients’ ADHD symptoms extend beyond the workday.

Get the Fact Sheet

References:

  1. American Psychiatric Association. Attention-deficit and disruptive behavior disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  2. Murphy KR, Adler LA. Assessing attention-deficit/hyperactivity disorder in adults: focus on rating scales. J Clin Psychiat. 2004;65[suppl 3]:12-17.
  3. Adler L, Cohen BA. Diagnosis and evaluation of adults with attention-deficit/hyperactivity disorder. Psychiatr Clin N Am. 2004;27:187-201.
  4. Kessler RC, Adler L, Ames M, et al. The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005;35:245-256.
  5. Kessler RC, Green JG, Adler LA, et al. Structure and diagnosis of adult attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2010;67(11):1168-1178.
  6. Goodman DW. ADHD in adults: update for clinicians on diagnosis and assessment. Prim Psychiatry. 2009;16(11):21-30.

DSM-5® is a registered trademark of the American Psychiatric Association.