ADHD: Types, Symptoms, and Diagnostic Overview

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. It affects children and adults.

Three Presentations (DSM-5)

1. Predominantly Inattentive Presentation (ADHD-PI)

Formerly called ADD. Core features:

• Difficulty sustaining attention in tasks or play
• Easily distracted by extraneous stimuli
• Frequent careless mistakes
• Appears not to listen when spoken to directly
• Struggles with organization and time management
• Avoids tasks requiring sustained mental effort
• Often loses items
• Forgetful in daily activities

Hyperactivity/impulsivity may be present but are not predominant.

2. Predominantly Hyperactive-Impulsive Presentation (ADHD-HI)

Core features:

• Fidgeting, tapping, squirming
• Leaves seat when remaining seated is expected
• Runs/climbs inappropriately (adults: restlessness)
• Unable to engage quietly in leisure
• “On the go” or acts as if “driven by a motor”
• Talks excessively
• Blurts answers, interrupts, intrudes
• Difficulty waiting turn

Inattention may be present but not predominant.

3. Combined Presentation (ADHD-C)

Significant symptoms of both inattention and hyperactivity-impulsivity. Most common presentation in children.

Diagnostic Criteria Highlights

• Symptoms present ≥6 months
• Several symptoms present before age 12
• Symptoms in ≥2 settings (home, school, work)
• Clear interference with social, academic, or occupational functioning
• Not better explained by another mental disorder

Important Notes

• Presentation can change over time (e.g., hyperactivity often decreases in adulthood).
• Adult ADHD often manifests as inattention, disorganization, and executive dysfunction.
• Comorbidities are common: anxiety, depression, learning disabilities, substance use.
• Diagnosis requires comprehensive clinical evaluation, not just checklists.