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 that begins in childhood and causes real impairment across daily life. It is common – affecting roughly 3–4% of adults – lifelong in most, and frequently under-recognised, particularly in girls and women, who are less likely to be referred and more likely to be misdiagnosed with another condition.

The single most important point for primary care is one of role: a GP does not diagnose ADHD or start medication. The GP recognises the pattern, assesses severity and impact, excludes mimics, 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), present in two or more settings (home, school/work, social), have begun in childhood, and 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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