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Guide des troubles cliniques

Attention-Deficit/
Hyperactivity Disorder

A neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development.

5-7%
Prévalence
~7
Âge d'apparition
2:1
Ratio
70-80%
Taux de réponse

Critères diagnostiques du DSM-5-TR

Predominantly Inattentive

6+ inattention symptoms (5+ for ages 17+)

  • • Fails to give close attention to details
  • • Difficulty sustaining attention
  • • Does not seem to listen
  • • Does not follow through on instructions
  • • Difficulty organizing tasks
  • • Avoids tasks requiring sustained mental effort
  • • Loses things necessary for tasks
  • • Easily distracted
  • • Forgetful in daily activities

Predominantly Hyperactive-Impulsive

6+ hyperactivity-impulsivity symptoms (5+ for ages 17+)

  • • Fidgets with hands/feet or squirms
  • • Leaves seat when remaining seated expected
  • • Runs/climbs inappropriately (restlessness in adults)
  • • Unable to engage quietly in leisure
  • • On the go or driven by a motor
  • • Talks excessively
  • • Blurts out answers
  • • Difficulty waiting turn
  • • Interrupts or intrudes on others

Combined Presentation

Meets criteria for both inattention AND hyperactivity-impulsivity

Most common presentation (~60% of diagnosed cases). Symptoms from both categories present simultaneously.

Protocoles d'évaluation

Outils validés pour le dépistage et le suivi de la sévérité

ASRS-5

Adult ADHD Self-Report Scale

6-item screener validated for adult ADHD detection in clinical settings.

Cotation :

4+ symptoms (often/very often) suggests ADHD; full 18-item version available for detailed assessment

Durée :2-5 minutes (screener), 5-10 minutes (full)

Conners 3

Conners Detailed Behavior Rating Scales

Multi-informant assessment for children/adolescents covering ADHD symptoms and related problems.

Cotation :

T-scores: <60 average, 60-64 high average, 65-69 elevated, 70+ very elevated

Durée :15-20 minutes per rater

CAARS

Conners Adult ADHD Rating Scales

Criterion-standard adult ADHD assessment with self-report and observer forms.

Cotation :

T-scores guide severity; DSM-5-TR symptom count aids diagnosis

Durée :10-15 minutes

BRIEF

Behavior Rating Inventory of Executive Function

Assesses real-world executive function deficits across 8 domains.

Cotation :

T-scores ≥65 clinically elevated; examines working memory, planning, organization

Durée :10-15 minutes

Causes et étiologie

Neurobiological

  • Frontostriatal circuit dysfunction (prefrontal cortex, basal ganglia)
  • Dopamine and norepinephrine dysregulation
  • Delayed cortical maturation (3-5 year lag in children)
  • Reduced volume in caudate nucleus, corpus callosum, cerebellum

Genetic

  • Heritability: 70-80% (strongest genetic component in psychiatry)
  • Polygenic risk involving 100+ genes
  • DRD4, DRD5, DAT1, 5-HTT genes implicated
  • First-degree relatives have 4-5x increased risk

Environmental

  • Prenatal exposure: nicotine, alcohol, lead
  • Prematurity and low birth weight
  • Traumatic brain injury in early childhood
  • Severe early deprivation (e.g., institutional rearing)

Neuropsychological

  • Executive function deficits: working memory, inhibition, planning
  • Delay aversion (preference for immediate rewards)
  • Temporal processing impairments
  • Arousal/activation regulation difficulties
Fondé sur des données probantes

Sources scientifiques

ASRS Validation

Kessler RC, Adler L, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale. Psychol Med. 2005;35(2):245-256.

DSM-5-TR Criteria

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). 2022.

Stimulant Medication Efficacy

Faraone SV, Biederman J, et al. Efficacy of stimulants for ADHD: A meta-analysis. J Atten Disord. 2004;7(4):205-214.

Neurobiological Mechanisms

Volkow ND, Wang GJ, et al. Evaluating dopamine reward pathway in ADHD. JAMA. 2009;302(10):1084-1091.

Genetic Studies

Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry. 2019;24(4):562-575.

Multimodal Treatment (MTA Study)

MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for ADHD. Arch Gen Psychiatry. 1999;56(12):1073-1086.

Recherche et actualités sur ADHD Clinical Guide: DSM-5-TR, ASRS Protocols and Treatment

Nouvelles, recherches et politiques récentes provenant de sources fiables.