CRITERIA FOR DIAGNOSIS AND TREATMENT STRATEGIES FOR ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic neurobiological condition that affects 5% to 7% of children and persists into adulthood in approximately 75% of cases, often accompanied by comorbidities. Its neurobiology involves dopaminergic and noradrenergic dysfunction in the corticostriatal and frontocerebellar circuits. This study aims to synthesize recent scientific evidence on the diagnostic criteria and therapeutic approaches for ADHD across the life span. A narrative literature review was conducted in the PubMed database using the MeSH terms “Attention Deficit Disorder with Hyperactivity,” “Diagnosis,” and “Therapeutics,” including articles from the past five years in English and Portuguese. The diagnosis of ADHD remains essentially clinical (DSM-5-TR and ICD-11), aided by instruments such as the ASRS, DIVA, and Conners scales. In the pediatric population, the effect of relative age in school leads to overdiagnosis, making a stepped-diagnosis approach recommended. In women, diagnosis is often delayed due to masked symptoms, while in the elderly population, the differential diagnosis with Mild Cognitive Impairment requires verification of symptom chronicity dating back to childhood. Clinical management requires an individualized approach based on a risk-benefit analysis, integrating non-pharmacological interventions (cognitive-behavioral therapy, physical exercise, augmented reality) and pharmacotherapy (psychostimulants as first-line treatment. non-stimulants in cases of intolerance or treatment failure). Given the lack of evidence regarding the durability of long-term effects, there is a clear need for randomized, longitudinal clinical trials to substantiate therapeutic efficacy, mitigate iatrogenic effects, and optimize personalized treatment.