Attention deficit hyperactivity disorder
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Synopsis

Typically, symptoms present before age 12. When diagnosed in adults, presenting symptoms include inattention, restlessness, and impulsivity but also involve emotional dysregulation (angry outbursts, low threshold of frustration) and executive dysfunction (trouble organizing and completing tasks, missing appointments or deadlines). Hoarding symptoms may be present in up to 25% of adults with ADHD.
The prevalence of ADHD is about 5% in pediatric and 2.5% in adult populations. In children, ADHD is twice as common in boys compared to girls; however, girls are more likely to present with predominantly inattentive symptoms. Smoking exposure during fetal development, low birth weight, and a first-degree relative with ADHD are associated with increased risk for developing ADHD.
Codes
ICD10CM:F90.9 – Attention-deficit hyperactivity disorder, unspecified type
SNOMEDCT:
406506008 – Attention Deficit Hyperactivity Disorder
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Normal variation in learning and cognition
- Autism spectrum disorder
- Stereotypic movement disorder
- Tourette syndrome
- Absence seizure
- Specific learning disorder: reading, writing, math
- Intellectual disability
- Oppositional defiant disorder
- Intermittent explosive disorder
- Anxiety disorders (see generalized anxiety disorder)
- Depressive disorders
- Bipolar disorder
- Disruptive mood dysregulation disorder
- Obsessive-compulsive disorder
- Personality disorders, particularly cluster B
- Psychotic disorder
- Neurocognitive disorder: dementia, early Alzheimer disease
- Substance use disorder
- Inattention or hyperactivity secondary to a medical disorder: hyperthyroidism, hypothyroidism, hearing loss, vision loss, obstructive sleep apnea, etc
- Medication-induced symptoms: bronchodilators, isoniazid, levothyroxine, etc
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References
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Last Reviewed:02/13/2020
Last Updated:02/23/2020
Last Updated:02/23/2020