What are the subtypes of ADHD

Subtypes

This article covers the Subtypes attention deficit / hyperactivity disorder as listed in DSM-5 and ICD-10. For general information about the disorder, see Attention Deficit / Hyperactivity Disorder.

The DSM-IV distinguishes between three subtypes in ADHD: ADHD of the mixed type, ADHD of the predominantly inattentive subtype and ADHD of the predominantly hyperactive-impulsive subtype. The ICD-10 also distinguishes between three subtypes: attention disorders without hyperactivity, hyperkinetic disorder of social behavior and simple attention and hyperactivity disorder.

Subtypes in the DSM-5

Predominantly hyperactive-impulsive appearance of ADHD

The subtype of the predominantly hyperactive-impulsive subtype was first recorded in the DSM-IV in 1994, as empirical studies have shown that a comparatively small percentage of people affected by ADHD show symptoms that are typical of ADHD, but that relate to the Limit hyperactivity and impulsivity. Those affected by the subtype seem to have less difficulty with attention. With regard to comorbid disorders, the subtype shows parallels to the mixed ADHD types.[1] Statistics show that boys are five times more likely to belong to the predominantly hyperactive-impulsive subtype than girls.[2]

Mostly inattentive appearance of ADHD

This subtype, like that of the hyperactive-impulsive subtype, can be found in the DSM-IV. The subtype is often described by the abbreviation ADS (without hyperactivity). Those affected by the predominantly inattentive subtype usually stand out due to their mental absence and reticence. In particular, when teachers report about students who stare out the window for a long time in class, who do not follow the lesson, paint or dream on their documents, there is a possibility that they are predominantly inattentive ADHD subtypes. It is also noticeable that those affected work considerably more slowly in work processes - even those that require less concentration - compared to others. Studies report that those affected by this subtype are comparatively less likely to notice externalizing comorbid symptoms (e.g. aggression, oppositional defiant behavior). The hypoactivity described by Helga Simchen is a synonym for the predominantly inattentive subtype. Girls are twice as likely to belong to the predominantly inattentive subtype as boys[2]

Combined appearance of ADHD

ADHD sufferers who stand out due to inattentiveness on the one hand, but also impulsiveness and overactivity on the other, are classified by the DSM as ADHD mixed types. It can be assumed that those affected have a particularly difficult time in comparison, since the fluctuating character of the symptoms creates an ambivalent external image.

Subtypes in the ICD-10

Disturbance in attention without hyperactivity

In contrast to the DSM-IV, which divides the ADH disorder on the basis of the main ADHD symptoms, the ICD-10 is based on the presence of a disorder of social behavior. Affected people who only stand out due to their inattentiveness, but not due to overactivity and impulsiveness, are diagnosed in the ICD-10 in this way.

Hyperkinetic conduct disorder

According to IDC-10, if those affected are noticed by increasingly occurring, aggressive behavior that is accompanied by inattentiveness, impulsiveness and hyperactivity, this indicates a hyperkinetic disorder with disorder of social behavior, according to IDC-10. Those affected have little inhibition against stealing or violent attacks.

Simple attention and hyperactivity disorder

If those affected do not attract attention due to antisocial behavior patterns, then, according to ICD-10 - provided that there are clear difficulties with long-term concentration - they fall under the subtype of simple attention and hyperactivity disorder.

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  1. ↑ Caterina Gawrilow, Textbook ADHD, p.25
  2. 2,02,1A. Baumgaertel, M. Wolraich, M. Dietrich: Comparison of diagnostic criteria for attention deficit disorder in a German elementary school sample. In: Journal of the American Academy of Child and Adolescent Psychiatry. 34: 629-638 (1995).