Attention Deficit Hyperactivity Disorder (ADHD)

🔍 When to Suspect

Persistent (≥6 months) symptoms of inattention, hyperactivity, and impulsivity present in multiple settings (e.g., home and school/work)

From the full topic in The Ocean Library: Attention Deficit Hyperactivity Disorder (ADHD)

🧭 When to suspect

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition defined by a persistent pattern of inattention and/or hyperactivity–impulsivity.

• The pattern begins in childhood and causes real impairment across daily life.

• Common – affecting roughly 3–4% of adults – and lifelong in most.

• Frequently under-recognised, particularly in girls and women, who are less likely to be referred and more likely to be misdiagnosed with another condition.

In primary care, know your role: a GP does not diagnose ADHD or start medication.

• The GP recognises the pattern, assesses severity and impact and excludes mimics.

• The GP refers for specialist assessment, and then supports the patient – including shared-care monitoring once treatment is established.

Core symptom domain	Typical features (children and adults)
Inattention	• Difficulty sustaining attention, easily distracted, forgetful, disorganised, loses things, careless mistakes, avoids sustained mental effort • In adults: poor time management, missed deadlines, half-finished tasks
Hyperactivity	Fidgeting, restlessness, difficulty staying seated, excessive talking, "always on the go". In adults: often an inner restlessness rather than overt overactivity.
Impulsivity	• Acts without thinking, interrupts, cannot wait their turn, blurts out answers • In adults: impulsive decisions, overspending, risk-taking and emotional dysregulation

To support a diagnosis, symptoms should:

• Be persistent (≥ 6 months).

• Be present in two or more settings (home, school/work, social).

• Have begun in childhood.

• Cause at least moderate impairment, meeting DSM-5 or ICD-11 criteria.

The formal diagnosis is made only by a specialist (child psychiatrist, paediatrician, or a specialist ADHD/adult mental health service).

Source: NICE NG87

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