아동․청소년 ADHD의 진단에서 기능장해 평가의 중요성 및 하위유형 간의 기능장해 비교
The Importance of Assessing Functional Impairment in The Diagnoses of ADHD in Children and Adolescents and a Comparison of Functional Impairment Across ADHD Subtypes
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To assess the importance of functional impairment, the first aim of the present study was to investigate the diagnostic consistency between symptom and impairment criteria of Attention-Deficit/Hyperactivity Disorder(ADHD). The second aim was to compare the functional impairment of children and adolescents with ADHD according to the different measures of impairment and to ADHD subtypes. Seventy-five children and adolescents who met the full symptom criteria of the DSM-IV ADHD algorithm were assessed for impairment. In order to assess the impairment, we used the Children's Global Assessment Scale(C-GAS), a certified global measure of disability and measures, and two other symptom-specific impairment measures that were included in the Kiddie-Schedule for Affective Disorders and Schizophrenia(K-SADS) and Diagnostic Interview Schedule for child version IV(DISC-IV). As a result, diagnostic consistency was 79.2% to 100%, varying according to the impairment measure used. In our sample, impairment in social functioning was the highest and problems with parents were salient. In addition, there were no differences in impairment between ADHD subtypes. These results imply that measuring impairment is important in the diagnostic procedure of ADHD, and that it is necessary to attend to such impairment in social functioning when treating children and adolescents with ADHD. Finally, the implications and limitations of this study and suggestions for future researches have been discussed.
Abstract
To assess the importance of functional impairment, the first aim of the present study was to investigate the diagnostic consistency between symptom and impairment criteria of Attention-Deficit/Hyperactivity Disorder(ADHD). The second aim was to compare the functional impairment of children and adolescents with ADHD according to the different measures of impairment and to ADHD subtypes. Seventy-five children and adolescents who met the full symptom criteria of the DSM-IV ADHD algorithm were assessed for impairment. In order to assess the impairment, we used the Children's Global Assessment Scale(C-GAS), a certified global measure of disability and measures, and two other symptom-specific impairment measures that were included in the Kiddie-Schedule for Affective Disorders and Schizophrenia(K-SADS) and Diagnostic Interview Schedule for child version IV(DISC-IV). As a result, diagnostic consistency was 79.2% to 100%, varying according to the impairment measure used. In our sample, impairment in social functioning was the highest and problems with parents were salient. In addition, there were no differences in impairment between ADHD subtypes. These results imply that measuring impairment is important in the diagnostic procedure of ADHD, and that it is necessary to attend to such impairment in social functioning when treating children and adolescents with ADHD. Finally, the implications and limitations of this study and suggestions for future researches have been discussed.
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