Commentary: The controversial DSM 5 was published in 2013, and in the past three years, even mainstream media has reported a rise in the use of stimulants among adults. With the DSM 5 requiring even fewer symptoms to make a diagnosis, according to this study, a significant increase of 65% in diagnosis was found.
This is concerning considering the link between stimulant use causing other psychiatric problems such as depression and bipolar disorder.
Compr Psychiatry. 2016 Jul;68:56-9. doi: 10.1016/j.comppsych.2016.03.008. Epub 2016 Mar 30.
New DSM-5 criteria for ADHD - Does it matter?
Rigler T1, Manor I2, Kalansky A3, Shorer Z4, Noyman I5, Sadaka Y6.
The new Diagnostic Statistical Manual (DSM) requires the presence of fewer symptoms to make a diagnosis of adult ADHD while the criteria for diagnosis in childhood are unchanged as compared to previous editions. This study examines the prevalence of adults meeting the revised DSM-5 symptoms cutoff as compared to the previous DSM-IV symptoms cutoff.
This study is part of a larger nationwide study that evaluated the use of, and the attitudes toward, ADHD medications by university students. 445 students from four major university faculties were surveyed and filled out questionnaires for our study.
The proportion of participants that met the minimum threshold of six out of nine current symptoms in either of the two DSM-IV symptom domains (inattentive presentation and hyperactive/impulsive presentation) for ADHD was 12.7% while the proportion that met the minimum threshold of five symptoms in either of the DSM-5 symptom domains was 21%.
Since the new DSM requires fewer current symptoms for a diagnosis of ADHD, a significant increase (65%) was observed in the number of participants meeting the new cutoff as compared to the old DSM-IV symptoms cutoff. This increase in the number of adults meeting symptoms cutoff may affect the rates of adults diagnosed with ADHD. Using the new criteria may identify more adults with ADHD and fewer diagnoses will be missed. However, meeting the new symptoms cutoff should be considered within the overall clinical context to prevent over-diagnosis.