【使用說明 / Notes】
本文件依照美國精神醫學學會《精神疾病診斷與統計手冊第五版文字修訂版》（DSM-5-TR）官方診斷標準整理而成，純文字條列格式，方便直接複製到任何平台分享，不使用表格。中文與英文逐條對照，方便核對原文用語。
This document is organized according to the official diagnostic criteria in the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision). Plain-text list format for easy copy-paste sharing; no tables used. Chinese and English are paired line by line for cross-reference.
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一、診斷框架總覽 / Diagnostic Framework Overview
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ADHD 症狀分為兩大類，共 18 條條目。
ADHD symptoms are divided into two categories, totaling 18 items.
A類：不注意型（Inattentive Presentation）
B類：過動與衝動型（Hyperactivity-Impulsivity Presentation）
診斷所需條件 / Criteria required for diagnosis：
症狀數量 / Symptom count：
17 歲以下兒童青少年，任一類至少符合 6 項。
For individuals age 16 or younger, at least 6 symptoms in either category.
17 歲及以上青少年與成人，任一類至少符合 5 項。
For individuals age 17 and older, at least 5 symptoms in either category.
持續時間 / Duration：
症狀須持續至少 6 個月。
Symptoms must have persisted for at least 6 months.
發病年齡 / Age of onset：
部分症狀須在 12 歲前已出現。
Several symptoms must have been present prior to age 12.
場合廣泛性 / Pervasiveness across settings：
症狀須在兩種以上場合出現，例如家庭、學校、職場、社交場合。
Symptoms must be present in two or more settings, such as home, school, work, or social situations.
功能損害 / Functional impairment：
症狀須造成社交、學業或職業功能的實質損害。
There must be clear evidence that symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
排除其他解釋 / Exclusion of other explanations：
症狀不能被其他精神疾病更好地解釋，例如精神分裂症、焦慮症、解離症、人格障礙。
The symptoms do not occur exclusively during the course of another mental disorder, such as schizophrenia, an anxiety disorder, a dissociative disorder, or a personality disorder.
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二、A類：不注意型症狀 / Inattentive Symptoms（9 條）
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- 常在工作、學業或其他活動中忽略細節或出現粗心錯誤。
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities. - 執行任務或活動時常難以維持注意力，例如上課、開會、閱讀時很快分心。
Often has difficulty sustaining attention in tasks or play activities, such as during lectures, conversations, or lengthy reading. - 別人直接對話時常似乎沒有在聽，思緒容易飄走。
Often does not seem to listen when spoken to directly, even in the absence of any obvious distraction. - 常無法遵循指示並完成作業、家務或工作職責，容易半途失去焦點。
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace. - 組織任務與活動有困難，例如時間管理差、東西擺放雜亂、工作缺乏順序。
Often has difficulty organizing tasks and activities, such as poor time management and messy, disorganized work. - 常迴避、不喜歡或不願從事需要持續腦力付出的任務，例如寫報告、填寫表格、閱讀長文件。
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, such as preparing reports or completing forms. - 常遺失工作或活動所需的物品，例如文件、鑰匙、眼鏡、手機、錢包。
Often loses things necessary for tasks or activities, such as school materials, keys, wallets, or mobile phones. - 容易被外部刺激或不相關的想法分心，成人可能表現為思緒無關的念頭不斷插入。
Is often easily distracted by extraneous stimuli or unrelated thoughts. - 日常活動中常健忘，例如忘記回電話、付帳單、赴約。
Is often forgetful in daily activities, such as returning calls, paying bills, or keeping appointments.
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三、B類：過動與衝動型症狀 / Hyperactivity-Impulsivity Symptoms（9 條）
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- 坐着時常動手動腳或在座位上扭動身體。
Often fidgets with or taps hands or feet, or squirms in seat. - 在需要維持坐姿的場合常常離座，例如課堂、會議、辦公室。
Often leaves seat in situations when remaining seated is expected. - 在不適合的場合中跑跳或爬走，成人可能只表現為內在強烈的躁動不安感。
Often runs about or climbs in situations where it is inappropriate; in adults, may be limited to feeling restless. - 很難安靜地參與休閒活動或遊玩。
Often unable to play or engage in leisure activities quietly. - 經常處於「不停活動」的狀態，難以長時間靜止，就像被馬達驅動一樣，讓周圍人覺得難以跟上或不自在。
Is often “on the go,” acting as if driven by a motor, and often uncomfortable being still for extended time. - 話說得過多。
Often talks excessively. - 別人問題還沒問完就搶著回答，或在對話中搶話插入。
Often blurts out an answer before a question has been completed. - 難以等待輪到自己，例如排隊、等待對話輪次時感到不耐煩。
Often has difficulty waiting his or her turn. - 常打斷或侵入別人的對話、遊戲或活動，未經他人允許擅自使用別人的物品。
Often interrupts or intrudes on others, such as butting into conversations or activities without asking permission.
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四、常見伴隨特徵，但非 DSM-5 正式診斷條目
Commonly Associated Features (NOT official DSM-5 diagnostic criteria)
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以下三項在臨床觀察與研究文獻中被廣泛認可為 ADHD 常見的相關特徵，但並未被 DSM-5-TR 列為正式診斷條目，使用時應明確區分於官方標準之外。
The following three features are widely recognized in clinical observation and research literature as commonly associated with ADHD, but are not listed as official diagnostic criteria in the DSM-5-TR, and should be clearly distinguished from the formal standard.
情緒調節困難 / Emotional Dysregulation：
情緒反應強度大、恢復速度慢，容易因小事被激怒或情緒瞬間爆發，之後又能相對快速平復。多數學者主張這是 ADHD 常見相關特徵，但非診斷必要條件。
Intense emotional reactions with slow recovery, easily triggered by minor events, often followed by relatively quick emotional recovery. Most researchers consider this a common associated feature, not a required diagnostic criterion.
時間感知困難 / Time Blindness：
難以估算時間流逝、規劃未來、掌握截止期限的緊迫性。此概念由學者 Russell Barkley 提出並廣泛使用，屬於臨床描述詞，非 DSM-5 正式病名。
Difficulty estimating the passage of time, planning ahead, and grasping the urgency of deadlines. This concept was proposed by researcher Russell Barkley and is widely used clinically, but is not an official DSM-5 diagnostic term.
拒絕敏感 / Rejection Sensitive Dysphoria（RSD）：
對批評、否定或被排除的情緒反應遠高於一般人。屬於臨床觀察到的常見現象，尚無獨立診斷標準或量化工具。
Emotional reactions to criticism, rejection, or exclusion that are far more intense than typical. A commonly observed clinical phenomenon without an independent diagnostic standard or validated measurement tool.
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五、重要提醒 / Important Reminder
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DSM-5-TR 強調症狀清單僅為篩檢輔助工具，真正的臨床診斷需要合格精神科醫師或臨床心理師，透過結構化訪談、發展史回顧（是否 12 歲前已出現症狀）、多場合功能損害證據，並排除其他精神疾病後才能確立。單靠自我評估清單無法取代專業診斷。
The DSM-5-TR emphasizes that this symptom checklist is only a screening aid. A genuine clinical diagnosis requires a qualified psychiatrist or clinical psychologist to conduct a structured interview, review developmental history (whether symptoms were present before age 12), gather evidence of functional impairment across settings, and rule out other mental disorders. A self-assessment checklist alone cannot replace professional diagnosis.
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