Disregarding Impairment in ADHD Diagnosis Inflates Its Prevalence

Abstract

Diagnostic and Statistical Manual of Mental Disorders–fifth edition ( DSM-V) diagnostic criteria for attention-deficit hyperactivity disorder (ADHD) has reemphasized impairment although many studies have demonstrated that such approach may inflate prevalence rates. However, there is no consensus on how impairment should be measured and a myriad of approaches in different studies make comparisons difficult. Objective: To investigate whether impairment measured using a previous validate quantitative measure modifies prevalence rates in a sample of Brazilian children and adolescents. Method: Of 109 children (72 males, 37 females), mean age of 12.4 years, 68 were with ADHD (according to DSM criteria, except for impairment) and 41 were typically developing children. All were evaluated with semi-structured interviews and completed the Functional Impairment Scale (FIS). Results: Thirty-five percent of ADHD cases had impairment in one single domain or no impairment at all (among school performance, social life, family life, and self-perception) in the FIS. Conclusion: Disregarding impairment clearly inflates ADHD diagnosis.

Linking ADHD and Behavioral Assessment Through Identification of Shared Diagnostic Task-Based Functional Connections

“…A clinical definition of ADHD is complicated by the prevailing view that it spans a continuum (Graham and Madigan, 2016) and exists as multiple subtypes (Garon et al, 2006). As of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), functional impairment became mandatory, however, even though the impact of ADHD has been well-studied, its fluid diagnostic criteria remain a challenge in research and clinical settings (Fortes et al, 2020). Moreover, though ADHD is diagnosable cognitive disorder in adults, the developmental stability of the diagnosis is quite poor (Todd et al, 2008).…”