COMPARISON OF DIAGNOSTIC-CRITERIA FOR ATTENTION-DEFICIT DISORDERS IN A GERMAN ELEMENTARY-SCHOOL SAMPLE

Objective: This study compares teacher-reported prevalence rates for d isruptive behavior disorders using DSM-IV DSM-III-R, and DSM-III crite ria within the same population of elementary school students and exami nes the relationships between DSM ''subtypes'' and academic performanc e, perceived behavior problems, and demographic variables. Method: Tea cher rating scales were obtained on 1,077 students in five rural and f ive urban public schools in Regensburg, Germany. Rating scales include d DSM-III-R items (attention-deficit hyperactivity disorder, oppositio nal defiant disorder, conduct disorder), DSM-IV items (attention-defic it/hyperactivity disorders [AD/HDs], oppositional defiant disorder), a nd DSM-III items (attention deficit disorder, with and without hyperac tivity). Factor analysis and analyses of significance were performed. Results: Overall prevalence for attention deficit disorders increased from 9.6% (DSM-III) to 17.8% (DSM-IV) primarily because of new cases i dentified as AD/HD-AD (inattentive type) and to a lesser degree, AD/HD -HI (hyperactive-impulsive type). Inattention in any subtype was assoc iated with academic problems, and perceived behavior problems were ass ociated with more than 80% of the cases that included hyperactivity-im pulsivity. DSM-IV AD/HD subtypes showed significant behavioral, academ ic, and demographic differences. Conclusion: Application of DSM-IV cri teria increased total AD/HD prevalence rates by 64% and identified the majority of children with academic and/or behavioral dysfunction. The data show significant heterogeneity between the subtypes and imply th at many children screened into these subtypes require further evaluati on to ensure appropriate management.