What the Doctor Will Use to Diagnose You
Understanding the diagnostic criteria and assessment tools healthcare professionals use to evaluate ADHD
DSM-5-TR (Text Revision) Criteria
Standard for: USA, UK (widely used in private practice), and research settings
Core Requirement: Impairment
Mere presence of symptoms is insufficient. The clinician must validate that these behaviors interfere with or reduce the quality of social, academic, or occupational functioning.
A. The Symptom Domains
Thresholds:
- • Children (up to 16): ≥6 symptoms in either domain
- • Adolescents & Adults (17+): ≥5 symptoms in either domain
Duration: Persistence for ≥6 months
Key Points:
- • Symptoms must be present in multiple settings
- • Must cause clear functional impairment
- • Not better explained by another condition
B. Severity Specifiers
Clinicians must assign a severity level based on the number of symptoms and degree of functional impairment:
Mild
Few symptoms beyond the required number; minor impairment in functioning
Moderate
Symptoms or functional impairment between "mild" and "severe"
Severe
Many symptoms in excess of those required, or several symptoms that are particularly severe, or marked impairment in social/occupational functioning
In Partial Remission
Full criteria were previously met, fewer than full criteria have been met for the past 6 months, but functioning is still impaired
ICD-11 Criteria (World Health Organization)
Standard for: UK (NHS default), Europe, and Global Health systems
Key Distinction from DSM-5
While DSM-5 strictly requires onset before age 12, ICD-11 is slightly more flexible, stating symptoms must be present in "early to mid-childhood." It places heavier emphasis on the lack of executive control.
6A05.0
Predominantly inattentive presentation
6A05.1
Predominantly hyperactive-impulsive presentation
6A05.2
Combined presentation
CCMD-3 (Chinese Classification of Mental Disorders)
Standard for: China and Chinese-speaking regions
China's Official Diagnostic System
The CCMD-3 (Chinese Classification of Mental Disorders, Third Edition) is China's official classification system for mental disorders, developed by the Chinese Society of Psychiatry in 2001. It harmonizes elements from ICD-10 and DSM-IV while incorporating culturally relevant adaptations.
According to surveys, 63.8% of Chinese psychiatrists primarily utilize CCMD-3 as their diagnostic tool, making it the most widely used classification system in China. ADHD is classified under Category 8: Behavioral and emotional disorders in childhood, with criteria that align with international standards while incorporating culturally relevant considerations.
Key Features
- • 10 main diagnostic categories (0-9)
- • Emphasizes clinical interviews and observation
- • Cultural adaptations for Chinese population
- • Similar structure to ICD-10 with regional specificity
ADHD Classification
ADHD is classified under Category 8: Behavioral and emotional disorders in childhood. The assessment criteria follow the same general principles as DSM-5 and ICD-11: symptoms must be primary, cause functional impairment, persist for the specified duration, and be assessed through clinical interviews, observation, and standardized scales where appropriate.
Learn More About CCMD-3
For a comprehensive guide to CCMD-3, including its full structure, assessment criteria examples, and detailed comparison with DSM and ICD systems, visit our dedicated CCMD-3 resource page. You can also take the CCMD-3 Self-Check screener to assess ADHD symptoms according to CCMD-3 criteria.
Clinical Interpretation & Assessment Tools
Doctors do not rely solely on self-reporting. They use a "Triangulation of Evidence" approach
A. The Diagnostic Interview
The clinician investigates three pillars:
Developmental History
Establishing that this is neurodevelopmental (born with it) rather than acquired (e.g., trauma or burnout). They look for school reports or parental testimony regarding behavior before age 12.
Cross-Setting Presence
Confirming symptoms appear in ≥2 settings (e.g., Home + Work, or Home + School). If a child is attentive at school but inattentive at home, it may be environmental, not ADHD.
Functional Impairment
Evidence of lost jobs, relationship strain, academic underachievement, or financial distress caused by symptoms.
B. Common Screening Scales used by Clinicians
DIVA-5
The Diagnostic Interview for ADHD in adults (structured interview)
ASRS v1.1
Adult ADHD Self-Report Scale (screener)
Conners' Rating Scales
Used for children/adolescents (filled out by parents and teachers)
C. The "Rule-Outs" (Differential Diagnosis)
Before diagnosing ADHD, a doctor must ensure symptoms are not better explained by:
Anxiety/Depression: Can cause concentration loss and restlessness
Bipolar Disorder: Manic episodes can mimic hyperactivity
Sleep Disorders: Sleep apnea or insomnia causes cognitive slowing and inattention
Thyroid Dysfunction: Hyperthyroidism mimics hyperactivity; hypothyroidism mimics inattention
Substance Use: Withdrawal or intoxication can mimic ADHD symptoms
Evolution of Symptoms: Child vs. Adult
ADHD looks different as the brain matures. The "Hyperactive" child often becomes the "Internalized" adult
| Symptom Category | Childhood Presentation | Adult Presentation |
|---|---|---|
| Hyperactivity | Running, climbing, unable to sit still in class | Internal restlessness, nervous energy, constant fidgeting, inability to "shut off" brain |
| Impulsivity | Pushing, grabbing toys, dangerous play | Impulse buying, quitting jobs suddenly, interrupting others, speeding/reckless driving |
| Inattention | Daydreaming, not doing homework | "Zoning out" in meetings, poor time management, difficulty finishing projects, chronic procrastination |
Ready to See How You Measure Up?
Now that you understand the diagnostic criteria, take our free assessment to see how your symptoms align with these professional standards.