Combined presentation ADHD, previously known as Combined Type ADHD, is one of the three presentations (or subtypes) of Attention Deficit Hyperactivity Disorder (ADHD) identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The other two presentations are Predominantly Inattentive Presentation and Predominantly Hyperactive-Impulsive Presentation. The combined presentation is characterized by symptoms of both inattention and hyperactivity-impulsivity that are persistent and impairing, occurring in more than one setting (e.g., at home, school, or work).
Individuals with the combined presentation of ADHD display a mixture of inattentive and hyperactive-impulsive symptoms. Key characteristics include:
The diagnosis of combined presentation ADHD requires a comprehensive evaluation that includes clinical interviews, and may also involve rating scales, observations, and potentially, neuropsychological testing. This evaluation aims to rule out other possible causes of symptoms, such as learning disorders or emotional disturbances, and to determine that the symptoms are not better explained by another mental disorder. The DSM-5 specifies that several symptoms should be present before the age of 12, be present in two or more settings (e.g., at home and school), and significantly impair social, academic, or occupational functioning.
Treatment for combined presentation ADHD often involves a multimodal approach, including:
The choice of treatment depends on the individual’s specific symptoms, age, and the presence of any coexisting conditions. Effective management often requires adjustments over time and collaboration among healthcare providers, parents, educators, and the individual with ADHD.
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