The contemporary concept of ADHD as defined in the DSM-IV-TR (American Psychiatric Association 2000) is relatively new. However, an analysis of historical literature suggests that children presenting with symptoms of inattention, hyperactivity, and impulsivity have previously been described by several authors during the last 200 years. The clinical characterizations, underlying concepts, and nomenclature of the described dysfunctions have changed over time. Many of the historical descriptions are, however, consistent with the modern diagnostic criteria for ADHD.
The first example of a disorder that appears to be similar to ADHD was given by Sir Alexander Crichton in 1798. Crichton was a Scottish physician who was born in Edinburgh in 1763. In 1785, he received his M.D. from the University of Leiden, The Netherlands (Palmer and Finger 2001; Tansey 1984). He then decided “to undertake a European medical tour” (Tansey 1984, p. 243) and practiced in hospitals in Paris, Stuttgart, and Vienna (Tansey 1984). In his clinical practice, Crichton observed many cases of insanity and became increasingly interested in mental illness (Palmer and Finger 2001). In 1798, he published “An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects”. In this work of three books, he demonstrated observations of clinical cases of mental illness (Palmer and Finger 2001). Up until the end of the eighteenth century, when Crichton published his inquiry, it was uncommon to focus on mental issues from a physiological or medical perspective (Palmer and Finger 2001). Crichton mentioned that at the time there were only two other authors who had “written fully on the subject of Mental Diseases” (Crichton 1798, pp. ii–iii, cited by Palmer and Finger 2001).
In this short description of the first alteration of attention, Crichton gives several indications that he was depicting the same disorder as defined in the current DSM-IV-TR criteria of ADHD. His characterization of the disorder as “the incapacity of attending with a necessary degree of constancy to any one object” is consistent with the second symptom of criterion A1, Inattention: the “difficulty sustaining attention in tasks or play activities” (American Psychiatric Association 2000). Crichton further describes that “this faculty is incessantly withdrawn from one impression to another”, which fits with a second DSM-IV-TR symptom of inattention, namely the circumstance that the patient “is often easily distracted by extraneous stimuli” (American Psychiatric Association 2000). The American Psychiatric Association (2000) furthermore determines that for the diagnosis of ADHD, the symptoms have to be present before the age of seven. Crichton also reports that the disorder can be “born with a person” and “when born with a person it becomes evident at a very early period of life” (Crichton 1798). The proximate conclusion that “it renders him incapable of attending with constancy to any one object of education” (Crichton 1798) suggests that Crichton observed school difficulties in these children, which are commonly seen in children with ADHD. Crichton states that the disorder “generally diminished with age” (Crichton 1798). The notion that ADHD is a disorder of childhood and affected children “grow out” of ADHD during puberty (Okie 2006) was common until the 1990s (Barkley 2006a). Recent studies have shown that about 50% of children diagnosed with ADHD retain symptoms of ADHD into adulthood (Okie 2006; Arolt 2008).
In common usage, people still sometimes use the term "ADD" to refer to attention deficit hyperactivity disorder (ADHD), particularly when discussing the inattentive presentation of the condition. However, "ADD" is no longer an official medical diagnosis.