Gomez Rapson, Chen Wai, Houghton Stephen
School of Science, Psychology, and Sport, Federation University, Melbourne 3806, Australia.
Curtin Medical School, Curtin University, Perth 6102, Australia.
World J Psychiatry. 2023 May 19;13(5):138-143. doi: 10.5498/wjp.v13.i5.138.
Current ICD-11 descriptions for attention deficit hyperactivity disorder (ADHD) were recently published online, in the same year as the DSM-5-TR (text revised edition) was released. In this commentary, we compare and contrast the DSM-5/DSM-5-TR and ICD-11 diagnostic criteria, summarize important differences, and underscore their clinical and research implications. Overall, three major differences emerge: (1) The number of diagnostic criteria for inattention (IA), hyperactivity (HY) and impulsivity (IM) symptoms (, DSM-5-TR has nine IA and nine HY/IM symptoms, whereas ICD-11 has 11 IA and 11 HY/IM sym-ptoms); (2) the clarity and standardization of diagnostic thresholds (, the diagnostic thresholds for symptom count in IA and HY/IM domains are explicitly specified in DSM-5-TR, whereas in ICD-11 they are not); and (3) the partitioning of HY and IM symptoms into sub-dimensions (, difference in partitioning HY and IM symptom domains relates to the differences between the current and previous editions of DSM and ICD, and this has important research implications). Currently, no ICD-11 based ADHD rating scales exist and while this absence represents an obstacle for respective research and clinical practice, it also presents opportunities for research development. This article highlights these challenges, possible remedies and novel research opportunities.
注意缺陷多动障碍(ADHD)的国际疾病分类第11版(ICD - 11)的最新描述最近已在网上发布,同年《精神疾病诊断与统计手册》第5版修订版(DSM - 5 - TR)也已发布。在这篇评论中,我们比较并对比了DSM - 5/DSM - 5 - TR和ICD - 11的诊断标准,总结了重要差异,并强调了它们在临床和研究方面的意义。总体而言,出现了三个主要差异:(1)注意力不集中(IA)、多动(HY)和冲动(IM)症状的诊断标准数量(DSM - 5 - TR有9项IA症状和9项HY/IM症状,而ICD - 11有11项IA症状和11项HY/IM症状);(2)诊断阈值的清晰度和标准化(DSM - 5 - TR明确规定了IA和HY/IM领域症状计数的诊断阈值,而ICD - 11中未明确规定);以及(3)HY和IM症状划分为子维度(HY和IM症状领域划分的差异与DSM和ICD当前版本与先前版本之间的差异有关,这具有重要的研究意义)。目前,不存在基于ICD - 11的ADHD评定量表,虽然这种缺失对各自的研究和临床实践构成了障碍,但也为研究发展提供了机遇。本文强调了这些挑战、可能的补救措施和新的研究机会。