title: Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample.
abstract: OBJECTIVE
  To examine teacher-reported prevalence rates for attention-deficit hyperactivity disorder (ADHD) based on DSM-III-R and DSM-IV in the same population.
  
  
  METHODS
  Teachers completed questionnaires in which they rated all their students on all DSM-III-R and DSM-IV symptoms for disruptive behavior disorders except for seven conduct disorder symptoms but including seven symptoms screening for anxiety or depression. This constituted all children in kindergarten through fifth grade in a middle Tennessee county during the 1993-1994 academic year (16 schools, 398 teachers, and 8,258 children). Also included were questions about the children's diagnosis of ADHD, treatment with stimulants, and the presence of behavior or academic problems.
  
  
  RESULTS
  The prevalence rates were 7.3% for ADHD (DSM-III-R); 11.4% for ADHD, total (TOT); 5.4% for ADHD, inattentive type (AD); 2.4% for ADHD, hyperactive-impulsive type (HI); and 3.6% for ADHD, combined type (CT). Factor analysis identified five factors: opposition/defiance-conduct, inattention, hyperactivity/impulsivity, anxiety/depression, and stealing-truancy. The rates of problems differed mostly between ADHD-AD and ADHD-HI (40% versus 80%) for behavior and (75% versus 23%) for academics. Few (15% to 40%) had an ADHD diagnosis or stimulant treatment (21% to 32%).
  
  
  CONCLUSIONS
  DSM-IV criteria are likely to increase the prevalence of this disorder in comparison with DSM-III-R rates, but they may better characterize its heterogeneity.
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Wolraich
authors.forename: J N
authors.initials: JN
authors.lastname: Hannah
authors.forename: T Y
authors.initials: TY
authors.lastname: Pinnock
authors.forename: A
authors.initials: A
authors.lastname: Baumgaertel
authors.forename: J
authors.initials: J
authors.lastname: Brown
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013663:Teaching; D013714:Tennessee / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D000078329:Workforce