de Schipper Elles, Mahdi Soheil, Coghill David, de Vries Petrus J, Gau Susan Shur-Fen, Granlund Mats, Holtmann Martin, Karande Sunil, Levy Florence, Almodayfer Omar, Rohde Luis, Tannock Rosemary, Bölte Sven
Paediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.
Child and Adolescent Psychiatry Stockholm, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
Eur Child Adolesc Psychiatry. 2015 Dec;24(12):1509-21. doi: 10.1007/s00787-015-0778-1. Epub 2015 Oct 1.
This is the second in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF and Children and Youth version, ICF-CY) core sets for attention deficit hyperactivity disorder (ADHD). The objective of this stage was to gather the opinions from international experts on which ability and disability concepts were considered relevant to functioning in ADHD. An email-based survey was carried out amongst international experts in ADHD. Relevant functional ability and disability concepts were extracted from their responses and linked to the ICF/-CY categories by two independent researchers using a standardised linking procedure. 174 experts from 11 different disciplines and 45 different countries completed the survey. Meaningful concepts identified in their responses were linked to 185 ICF/-CY categories. Of these, 83 categories were identified by at least 5 % of the experts and considered the most relevant to ADHD: 30 of these were related to Body functions (most identified: attention functions, 85 %), 30 to Activities and Participation (most identified: school education, 52 %), 20 to Environmental factors (most identified: support from immediate family, 61 %), and 3 to Body structures (most identified: structure of brain, 83 %). Experts also provided their views on particular abilities related to ADHD, naming characteristics such as high-energy levels, flexibility and resiliency. Gender differences in the expression of ADHD identified by experts pertained mainly to females showing more internalising (e.g. anxiety, low self-esteem) and less externalising behaviours (e.g. hyperactivity), leading to a risk of late- and under-diagnosis in females. Results indicate that the impact of ADHD extends beyond the core symptom domains, into all areas of life and across the lifespan. The current study in combination with three additional preparatory studies (comprehensive scoping review, focus groups, clinical study) will provide the scientific basis to define the ADHD ICF/-CY core sets for multi-purpose use in basic and applied research and every day clinical practice.
这是四项实证研究系列中的第二项，旨在制定注意缺陷多动障碍（ADHD）的《国际功能、残疾和健康分类》（ICF，儿童和青少年版为ICF-CY）核心集。此阶段的目标是收集国际专家对于哪些能力和残疾概念被认为与ADHD功能相关的意见。在ADHD国际专家中开展了一项基于电子邮件的调查。从他们的回复中提取了相关的功能能力和残疾概念，并由两名独立研究人员使用标准化的关联程序将其与ICF/CY类别相联系。来自11个不同学科和45个不同国家的174名专家完成了该调查。在他们的回复中确定的有意义的概念与185个ICF/CY类别相联系。其中，83个类别被至少5%的专家认定，并被认为与ADHD最相关：其中30个与身体功能相关（最常被提及的是注意力功能，占85%），30个与活动和参与相关（最常被提及的是学校教育，占52%），20个与环境因素相关（最常被提及的是直系亲属的支持，占61%），3个与身体结构相关（最常被提及的是脑结构，占83%）。专家们还就与ADHD相关的特定能力发表了看法，列举了如高能量水平、灵活性和适应力等特征。专家们确定的ADHD表现中的性别差异主要在于，女性表现出更多内化行为（如焦虑、自卑）和更少外化行为（如多动），这导致女性存在诊断延迟和漏诊的风险。结果表明，ADHD的影响超出了核心症状领域，延伸到生活的各个方面以及整个生命周期。当前这项研究与另外三项预备性研究（全面的范围综述、焦点小组、临床研究）相结合，将为定义用于基础和应用研究以及日常临床实践的多用途ADHD ICF/CY核心集提供科学依据。
