A 7-year-old boy is brought for being disruptive in class, unable to sit still, frequently interrupting others, and making careless mistakes despite apparently good intelligence. Symptoms occur across home and school settings for >6 months. DSM-5 criteria for ADHD require symptoms in how many settings, for what duration, and before what age of onset?

• A One setting, 3 months, before age 5
• B Two or more settings, 12 months, before age 7
• C Three settings, 6 months, before age 16
• D Two or more settings, 6 months, before age 12 ✓

Explanation

DSM-5 ADHD criteria require: ≥6 symptoms of inattention and/or hyperactivity-impulsivity (≥5 in adolescents/adults ≥17 years); present in TWO or more settings (home, school, work); for at least 6 months; with several symptoms present before age 12 (changed from 7 in DSM-IV); causing significant functional impairment. Methylphenidate is the first-line pharmacotherapy in children.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.