Specifiy based on current presentation
Combined presentation: If both criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
Predominantly inattentive presentation: If criterion A1 (inattention) is met, but criterion A2 (hyperactivity-impulsivity) is not met, and three or more symptoms from criterion A2 have been present for the past 6 months.
Inattentive presentation (restrictive): If criterion A1 (inattention) is met, but no more than two symptoms from criterion A2 (hyperactivityimpulsivity) have been present for the past 6 months.
Predominantly hyperactive/impulsive presentation: If criterion A2 (hyperactivity-impulsivity) is met, and criterion A1 (inattention) is not met for the past 6 months.
Coding note: For individuals (especially adolescents and adults) who currently have symptoms with impairment that no longer meet full criteria, ‘‘in partial remission’’ should be specified.
approach this markedly different. As mentioned later in this paper, subtypes are changed into presentations and a fourth option will be available, namely the restrictive inattentive presentation. What in DSM-IV could be interpreted, as a ‘‘sluggish cognitive tempo-subtype’’ is no longer mentioned directly, but a specific presentation with very few hyperactive/impulsive symptoms is now described and the exact criteria for this disorder are put forward. Instead of ADHD-NOS, the proposal suggests a new disorder, namely ADHD-not elsewhere classified, which may be coded ‘‘in cases in which the individuals are below threshold for ADHD or for whom there is insufficient opportunity to verify all criteria’’.
The changes from subtypes into presentations
The three DSM-IV subtypes of ADHD are changed into four different presentations:
1. Combined presentation requiring six inattentive and six hyperactive/impulsive symptoms (identical with DSM-IV ADHD combined type).
2. Predominantly inattentive presentation requiring six inattentive and 3–5 hyperactive/impulsive symptoms (all children fulfilling this new criteria would have fulfilled criteria for DSM-IV ADHD inattentive type, but not vice versa).
3. Inattentive presentation (restrictive) requiring six inattentive and no more than two hyperactive/impulsive symptoms (all children fulfilling this new criteria would have fulfilled criteria for DSM-IV ADHD inattentive type).
4. Predominantly hyperactive/impulsive presentation requiring six hyperactive/impulsive symptoms (all children fulfilling this new criteria would have fulfilled criteria for DSM-IV ADHD hyperactive/impulsive type).
Overall, this change will not include or exclude more patients fulfilling criteria for the disorder, but simply subcategorize them differently. However, it may smooth out the differences among the presentations 1, 2, and 4 and reduce heterogeneity.