## DSM-5 Diagnostic Criteria for ADHD **Key Point:** The critical distinguishing feature of ADHD is that symptoms must be present across MULTIPLE settings, not confined to a single environment. This multi-setting requirement is essential to rule out situational behavioral problems. ### Core Diagnostic Requirements | Criterion | Requirement | Notes | |-----------|-------------|-------| | **Symptom onset** | Before age 12 years | Childhood-onset disorder | | **Duration** | ≥6 months | Persistent, not transient | | **Functional impairment** | Present in functioning/development | Must cause actual harm | | **Setting requirement** | **Multiple settings** (home, school, work) | NOT single setting | | **Symptom count** | Inattention: ≥6 (age <17) or ≥5 (age ≥17); Hyperactivity-impulsivity: ≥6 (age <17) or ≥5 (age ≥17) | Threshold varies by age | **High-Yield:** The multi-setting requirement distinguishes ADHD from: - Situational behavioral problems (e.g., only disruptive at school due to poor teacher fit) - Adjustment disorders (context-specific) - Oppositional defiant disorder in isolation **Clinical Pearl:** A child who is hyperactive only at home but perfectly behaved at school does NOT meet ADHD criteria — this pattern suggests parenting issues, family stressors, or environmental mismatch rather than neurodevelopmental ADHD. **Warning:** Clinicians often miss the multi-setting requirement. Collateral information from both parents AND teachers is mandatory for accurate diagnosis in children.
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.