ADHD — MRCPsych Paper B MCQ

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EasyChild & Adolescent PsychiatryADHDMRCPsych Paper B

An 8-year-old boy is assessed by CAMHS because he is unable to remain seated in class, frequently interrupts others, cannot wait his turn, regularly loses things and often fails to follow instructions. His parents report the same pattern at home over the past 2 years. These difficulties are developmentally inappropriate and have caused a decline in his academic performance. Which diagnosis best accounts for this presentation?

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Correct answer: C — Attention deficit hyperactivity disorder

The best answer is attention deficit hyperactivity disorder (ADHD). He has inattentive features, including losing things and failing to follow instructions, together with hyperactive and impulsive features, including leaving his seat, interrupting and difficulty waiting. The persistent pattern occurs at home and school and causes educational impairment, matching the central diagnostic features specified by NICE. A formal diagnosis requires specialist clinical and psychosocial assessment rather than symptom counting alone. Autism spectrum disorder would require characteristic social-communication differences and restricted or repetitive behaviour. Conduct disorder involves a persistent pattern violating others’ rights or major age-appropriate rules, rather than distractibility and impulsivity alone. Social anxiety would produce fear and avoidance of scrutiny, while selective mutism involves consistent failure to speak in particular social situations.

Reference: National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management (NG87), section 1.3, Diagnosis. 2018, updated 2019 and reviewed 2025. https://www.nice.org.uk/guidance/ng87/chapter/recommendations