COMPARISON OF DIAGNOSTIC-CRITERIA FOR ATTENTION-DEFICIT HYPERACTIVITYDISORDER IN A COUNTY-WIDE SAMPLE

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. Method: Teachers completed questionnaires in whi ch they rated all their students on all DSM-III-R and DSM-IV symptoms for disruptive behavior disorders except for seven conduct disorder sy mptoms but including seven symptoms screening for anxiety or depressio n. This constituted all children in kindergarten through fifth grade i n a middle Tennessee county during the 1993-1994 academic year (16 sch ools, 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 prevalenc e 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-impuls ive type (HI); and 3.6% for ADHD, combined type (CT). Factor analysis identified five factors: opposition/defiance-conduct, inattention, hyp eractivity/impulsivity, anxiety/depression, and stealing-truancy. The rates of problems differed mostly between ADHD-AD and ADHD-HI (40% ver sus 80%) for behavior and (75% versus 23%) for academics. Few (15% to 40%) had an ADHD diagnosis or stimulant treatment (21% to 32%). Conclu sion: DSM-IV criteria are likely to increase the prevalence of this di sorder in comparison with DSM-III-R rates, but they may better charact erize its heterogeneity.