title: [The clinical impairment of children with Attention Deficit Hyperactivity Disorder: problematic of diagnostic criteria].
abstract: One important consideration in the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), as set forth in the criterion D of DSM-IV, is the assessment of clinically significant impairment in social and academic functioning. Despite the avowed importance in the assessment of ADHD, there is little guidance in DSM-IV in defining impairment. Rating scales assessing impairment are few in number and rarely used in clinical practice. Overlooking impairment in diagnostic approaches has strong clinical implications, leading to false positive or false negative diagnoses. The relation between impairment and symptoms remains currently undefined and a controversial field in the ADHD literature, as many children can display the full range of ADHD symptoms without necessarily displaying significant impairment in their functioning. The relation between symptoms and impairment is more obvious in older children, where domains of impairment are more expanded. This finding suggests that symptoms and impairment are related, but yet there are distinct domains that should be measured independently to confirm the presence of ADHD. In conclusion, an operational definition of impairment, valid measures and diagnostic decision rules for incorporating impairment into the assessment of ADHD is warranted. Additional research is also needed to determine whether the age of onset of symptoms (before the age of seven) is different or should be separated from the age of onset of impairment.
authors: M
authors: M
authors: Skounti
authors: A
authors: A
authors: Bitzaraki
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D006115:Greece; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012920:Social Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy