What are the different subtypes of ADD/ADHD?

[Punchy71]

Hi all,

I am new to the forum and this subject in general. How many different types (or "subtypes") of ADD/ADHD are there and what are they called (or named or labeled, however you choose to say it) and what are their symptoms? Are these officially recognized by the medical community and documented and if so, who by? Or does each person have their own individual unique case with a unique set of symptoms that can't (or shouldn't) be lumped in with each category so easily?

Thank you

[namazu]

Originally Posted by Punchy71

I am new to the forum and this subject in general. How many different types (or "subtypes") of ADD/ADHD are there and what are they called (or named or labeled, however you choose to say it) and what are their symptoms? Are these officially recognized by the medical community and documented and if so, who by?

Depends who you ask.

One major reference on psychiatric disorders (published by the American Psychiatric Association), the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- in the current edition -- give three main "subtypes" of ADHD:

- Combined Type (with significant symptoms of both inattention and hyperactivity/impulsivity)

- Predominantly Inattentive Type (with significant symptoms of inattention, but not enough hyperactive/impulsive symptoms to fit the "combined type")

- Predominantly Hyperactive-Impulsive Type (with significant symptoms of hyperactivity/impulsivity, but not enough inattentive symptoms to fit the "combined type")

There's also a separate category for "ADHD -- Not Otherwise Specified", which is kind of a grab-bag of people who have symptoms that seem to reflect a disorder of attention that don't quite meet the regular ADHD criteria for some reason, but who are really having significant problems due to these symptoms.

There will be a new version of the DSM coming out...probably next year sometime...and they're going to change the way they slice things.

There's evidence that the subtypes above aren't really stable over time -- kids diagnosed with Primarily Hyperactive-Inattentive subtype often end up looking more "Combined", some people lose some hyperactivity as they age and go from "Combined" to "Predominantly Inattentive" under the current criteria, etc.

So they're collapsing the 3 current ADHD subtypes (Combined, PI, PH-I) into a single ADHD diagnosis. (Then the clinician can use subtype-like terms to describe the current "presentation" of the ADHD.) You can read about the proposed changes here -- and if you click on the "DSM-IV" tab, you can read the current diagnostic criteria/key symptom lists for the current subtypes, too.

But there are other ways to classify things, too. The International Classification of Diseases (ICD) uses different labels, and puts more emphasis on whether someone also has a conduct disorder.

Some researchers want to define a "sluggish congitive tempo" category for people who have a lot of daydreaminess, mental fogginess, slow responses, etc. -- which may or may not overlap with the ADHD categories.

And various others have suggested different categorizations, based on coexisting disorders, brain scan patterns, genes, etc. But the most common "official" categorization you'll see is the DSM version.

Or does each person have their own individual unique case with a unique set of symptoms that can't (or shouldn't) be lumped in with each category so easily?

...But yes, this also has truth to it.

Diagnostic labels are shorthand descriptions for behaviors or medical problems. They can be useful for insurance reimbursement. They can be useful in making group comparisons. They can be useful in taking a first guess at how to treat the problem.

We may get closer to understanding the individual variation within the categories (and maybe change some of the categories) as we learn more about the brain, about development, about genes and epigenetics, and so on.

But labels exist to simplify complex situations, and no label will perfectly capture all of the individual variation that exists.