ADHD Diagnoses Up with DSM-5 Age Criteria

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Prevalence of all subtypes of attention-deficit/hyperactivity disorder has increased since the DSM-5 increased the age-of-onset criteria from 7 to 12 years, but particularly among those with the inattentive subtype of the disease, according to researchers.

The overall prevalence of ADHD increased from 7.38% using the DSM-IV criteria to 10.84% with the DSM-5, Kathleen R. Merikangas, PhD, of the National Institute of Mental Health in Bethesda, Maryland, and colleagues reported in Child & Adolescent Psychiatry.

They examined a representative sample of 1,894 youth aged 12 to 15 years who participated in the National Health and Nutrition Examination surveys from 2001 and 2004 to determine the impact of extending the age-of-onset criterion.

The greatest increases in ADHD prevalence was noted among patients with the inattention subtype of ADHD. These patients tend to have later onset symptom and are less likely to be recognized and treated because their problems may be less apparent at home and school, according to the researchers.

“The comparability of the clinical significance of the early and later age-of-onset groups supports the DSM-5 extension of the age-of-onset criterion in ADHD,” the researchers wrote.

Patients with later ADHD onset did not have more severe forms of the disease or higher rates of comorbidities than those with earlier onset disease.

How Has the DSM-5 Change in Age-of-Onset Criteria Impacted ADHD?
How Has the DSM-5 Change in Age-of-Onset Criteria Impacted ADHD?

The study aims to compare the prevalence and clinical correlates of DSM-IV versus DSM-5–defined attention deficit hyperactivity disorder (ADHD) and subtypes in a nationally representative sample of US youth based on the age-of-onset criterion.

The comparability of the clinical significance of the early and later age-of-onset groups supports the DSM-5 extension of the age-of-onset criterion in ADHD.

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