Adult ADHD and comorbid depression: A consensus-derived diagnostic algorithm for ADHD

ICD-10 Criteria for Diagnosis of Hyperkinetic Disorders. Reproduced with permission from: World Health Organization. The ICD-10 Classification of mental and behavioural disorders: Diagnostic Criteria for Research. Geneva: Author, 1993, p155–157. F90. Hyperkinetic disorders. Note: The research diagnosis of hyperkinetic disorder requires the definite presence of abnormal levels of inattention, hyperactivity, and restlessness that are pervasive across situations and persistent over time and that are not caused by other disorders such as autism or affective disorders. G1. Inattention. At least six of the following symptoms of inattention have persisted for at least six months, to a degree that is maladaptive and inconsistent with the developmental level of the child: often fails to give close attention to details, or makes careless errors in schoolwork, work, or other activities; often fails to sustain attention in tasks or play activities; often appears not to listen to what is being said to him or her; often fails to follow through on instructions or to finish schoolwork, chores, or duties in the workplace (not because of oppositional behaviour or failure to understand instructions); is often impaired in organizing tasks and activities; often avoids or strongly dislikes tasks, such as homework, that require sustained mental effort; often loses things necessary for certain tasks or activities, such as school assignments, pencils, books, toys, or tools; is often easily distracted by external stimuli; is often forgetful in the course of daily activities. G2. Hyperactivity. At least three of the following symptoms of hyperactivity have persisted for at least 6 months, to a degree that is maladaptive and inconsistent with the developmental level of the child: often fidgets with hands or feet or squirms on seat; leaves seat in classroom or in other situations in which remaining seated is expected; often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, only feelings of restlessness may be present); is often unduly noisy in playing or has difficulty in engaging quietly in leisure activities; exhibits a persistent pattern of excessive motor activity that is not substantially modified by social context or demands. G3. Impulsivity. At least one of the following symptoms of impulsivity has persisted for at least 6 months, to a degree that is maladaptive and inconsistent with the development level of the child: often blurts out answers before questions have been completed; often fails to wait in lines or await turns in games or group situations; often interrupts or intrudes on others (eg, butts into others’ conversations or games); often talks excessively without appropriate response to social constraints. G5. Onset of the disorder is no later than the age of 7 years. G5. Pervasiveness. The criteria should be met for more than a single situation, eg, the combination of inattention and hyper-activity should be present both at home and at school, or at both school and another setting where children are observed, such as a clinic. (Evidence for cross-situationality will ordinarily require information from more than one source; parental reports about classroom behaviour, for instance, are unlikely to be sufficient). G6. The symptoms in G1–G3 cause clinically significant distress or impairment I social, academic, or occupational functioning. G7. The disorder does not meet the criteria for pervasive developmental disorders (F84.-), manic episode (F30.-), depressive episode (F32.-), or anxiety disorders (F41.-).