Predictive validity of DSM-IV and ICD-10 criteria for ADHD and hyperkinetic disorder
Predictive validity of DSM-IV and ICD-10 criteria for ADHD and hyperkinetic disorder
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DOI：
10.1111/j.1469-7610.2007.01784.x
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发表时间：
2008-01-01
影响因子：
7.6
通讯作者：
Ickowicz, Abel
中科院分区：
文献类型：
--
作者：
Lee, Soyoung I.;Schachar, Russell J.;Ickowicz, Abel
背景资料：本研究的目的是比较儿童多动症的两种主要诊断模式-注意力缺陷多动障碍（ADHD;诊断和统计手册- IV）和多动症（HKD;国际疾病分类-第10版）的预测有效性。研究方法：根据ADHD和HKD的诊断标准，将419名6至16岁的儿童分为4组：HKD，ADHD联合亚型（ADHD-C），ADHD多动-冲动亚型（ADHD-HI），ADHD注意力不集中亚型（ADHD-IA）。比较这些组的临床特征，包括总症状严重程度，整体损害，暴露于心理社会和神经发育风险，一级家族成员的ADHD家族史，合并症的发生率和类型，智力，学业成绩，以及运动反应抑制和工作记忆的实验室测试，并与正常对照组进行比较（47）。结果：419例中HKD 46例（11.0%），ADHD-C 200例（47.7%），ADHD-HI 60例（14.3%），ADHD-IA 113例（27.0%）。香港迪士尼乐园组较其他组别有更多病征，而教师评分亦较其他组别受损。ADHD-C组和HKD组的抑制控制能力低于ADHD-IA组、ADHD-HI组和对照组，且4个临床组均表现出抑制缺陷。各组在工作记忆方面没有差异。与对照组相比，HKD组、ADHD-C组、ADHD-HI组和ADHD-IA组的ADHD家族风险较高，心理社会风险暴露较大，智力水平较低，学业成绩较差。然而，我们没有观察到这些特征在临床组之间的差异。结论：与早期版本一样，ICD-10和DSM-IV继续描述临床样本中患病率差异很大的诊断实体。然而，HKD、ADHD-C、ADHD-IA和ADHD-HI组在重要临床特征方面基本重叠，尽管HKD和ADHD-C可能比ADHD-IA和ADHD-HI更严重。
Background: The goal of this study was to compare the predictive validity of the two main diagnostic schemata for childhood hyperactivity - attention-deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual - IV) and hyperkinetic disorder (HKD; International Classification of Diseases - 10th Edition). Methods: Diagnostic criteria for ADHD and HKD were used to classify 419 children ages 6 to 16 years referred to a clinic for behavioral problems into one of four groups: HKD, ADHD combined subtype (ADHD-C), ADHD hyperactive-impulsive subtype (ADHD-HI), ADHD inattentive subtype (ADHD-IA). These groups were compared on clinical characteristics including total symptom severity, overall impairment, exposure to psychosocial and neuro-developmental risks, family history of ADHD in first-degree family members, rate and type of comorbidity, intelligence, academic achievement, and on laboratory tests of motor response inhibition and working memory with each other and with normal controls (47). Results: Of the 419 cases, there were 46 HKD (11.0%), 200 ADHD-C (47.7%), 60 ADHD-HI (14.3%) and 113 ADHD-IA (27.0%) cases. The HKD group had more symptoms and was more impaired on teachers' ratings than were the other groups. The ADHD-C and HKD groups had poorer inhibitory control than the ADHD-IA, ADHD-HI and control groups, and all four clinic groups showed inhibition deficit compared to controls. Groups did not differ in working memory. Compared to controls, the HKD, ADHD-C, ADHD-HI and ADHD-IA groups had higher familial risk of ADHD, greater psychosocial risk exposure, lower intellectual level and poorer academic attainment. However, we observed no differences among the clinic groups in these characteristics. Conclusions: Like earlier versions, ICD-10 and DSM-IV continue to delineate diagnostic entities with substantially different prevalence in clinic samples. However, HKD, ADHD-C, ADHD-IA and ADHD-HI groups overlap substantially in terms of important clinical characteristics, although HKD and ADHD-C may be somewhat more severe variants of the condition than ADHD-IA and ADHD-HI.