ABSTRACT
Los criterios diagnósticos para el trastorno por déficit de atención/hiperactividad (TDAH) fueron definidos por la clasificación estadística de las enfermedades mentales propuestas por el consenso de la Asociación Americana de Psiquiatría en el Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición (DSM-IV) y la Organización Mundial de la Salud en la Clasificación Internacional de Enfermedades, décima revisión. La Asociación Americana de Psiquiatría utilizó un análisis de validez interna para seleccionar los síntomas específicos asociados con el trastorno y construir cinco criterios transculturales para realizar el diagnóstico categórico. El DSM ha sido usado por los clínicos y los investigadores como una herramienta estable y válida desde 1968. La presente revisión busca identificar el origen de la validez del diagnóstico de TDAH según el sistema clasificatorio propuesto por este manual. Para tal efecto, y con base en el desarrollo histórico del trastorno, se parte de la revisión documental exhaustiva de un amplio cuerpo de publicaciones en inglés y español que hacen referencia a los conceptos clínicos de disfunción cerebral mínima, hiperactividad, inatención e impulsividad desde 1932 hasta 2011. Posteriormente, se establece una descripción de las metodologías estadísticas usadas en las diversas clasificaciones y definiciones de las diferentes versiones del DSM para establecer al TDAH como un constructo válido desde el punto de vista psicométrico y epidemiológico. Finalmente, se analizan y discuten algunos elementos relacionados con los cambios que se pudieran introducir en las futuras versiones del manual (AU)
The diagnostic criteria for the attentional deficit hyperactivity disorder (ADHD), were defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders fourth version (DSM-IV) and World Health Organization in the ICD-10. The American Psychiatric Association used an internal validity analysis to select specific behavioral symptoms associated with the disorder and to build five cross-cultural criteria for its use in the categorical diagnosis. The DSM has been utilized for clinicians and researchers as a valid and stable approach since 1968. We did a systematic review of scientific literature in Spanish and English, aimed to identify the historical origin that supports ADHD as a psychiatric construct. This comprehensive review started exploring the concept of minimal brain dysfunction, hyperactivity, inattention, impulsivity since 1932 to 2011. This paper summarize all the DSM versions that include the definition of ADHD or its equivalent, and it point out the statistical and methodological approach implemented for defining ADHD as a valid epidemiological and psychometric construct. Finally the paper discusses some considerations and suggestions for the new versions of the manual (AU)
Subject(s)
Humans , Male , Female , Child , Attention Deficit Disorder with Hyperactivity/diagnosis , Reproducibility of Results/instrumentation , Attention Deficit Disorder with Hyperactivity/classification , Diagnostic and Statistical Manual of Mental DisordersABSTRACT
The diagnostic criteria for the attentional deficit hyperactivity disorder (ADHD), were defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders fourth version (DSM-IV) and World Health Organization in the ICD-10. The American Psychiatric Association used an internal validity analysis to select specific behavioral symptoms associated with the disorder and to build five cross-cultural criteria for its use in the categorical diagnosis. The DSM has been utilized for clinicians and researchers as a valid and stable approach since 1968. We did a systematic review of scientific literature in Spanish and English, aimed to identify the historical origin that supports ADHD as a psychiatric construct. This comprehensive review started exploring the concept of minimal brain dysfunction, hyper-activity, inattention, impulsivity since 1932 to 2011. This paper summarize all the DSM versions that include the definition of ADHD or its equivalent, and it point out the statistical and methodological approach implemented for defining ADHD as a valid epidemiological and psychometric construct. Finally the paper discusses some considerations and suggestions for the new versions of the manual.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Humans , Neurobiology , Reproducibility of ResultsABSTRACT
INTRODUCTION: The Wender-Utah Rating Scale (WURS) has been used for retrospective screening of attention deficit hyperactivity disorders (ADHD) symptoms and its comorbidities. AIM: To establish the ADHD behavioral phenotype dimensions of adults from 140 Antioquian families with genetic segregation for ADHD diagnosis, using the WURS -Spanish version. SUBJECTS AND METHODS: 392 adults from both genders, belonging to nuclear and multigenerational families with one or more ADHD affected members were selected. The Composite International Diagnostic Interview (CIDI) for mental disorder was administered to establish the gold standard diagnosis of ADHD through the long life. All participants fulfill the WURS. Exploratory and confirmatory factor analyses were done to determine the behavioral dimensions of the ADHD phenotype. RESULTS: A factor structure of four dimensions was derived, measuring behavioral decontrol, hyperactivity, inattention and anxiety, and which explained the 60% of the total variance. CONCLUSIONS: The behavioral adult ADHD phenotype in the Antioquian families was conformed by four dimensions, which could be used in heritability and linkage future studies.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/physiopathology , Behavior/physiology , Psychiatric Status Rating Scales , Adult , Attention Deficit Disorder with Hyperactivity/genetics , Comorbidity , Female , Humans , Male , Middle Aged , Personality Assessment , Personality Inventory , Phenotype , Retrospective Studies , Spain , Surveys and QuestionnairesABSTRACT
Introducción. El cuestionario Wender-Utah (WURS) se ha empleado en la evaluación retrospectiva de los síntomas del trastorno por déficit de atención/hiperactividad (TDAH) y sus comorbilidades en adultos. Objetivo. Establecer las dimensiones del fenotipo de las conductas del TDAH y sus comorbilidades en adultos de 141 familias de Antioquia con segregación para el diagnóstico de TDAH, usando la WURS en español. Sujetos y métodos. Se tomaron 392 adultos de ambos sexos pertenecientes a las familias nucleares y multigeneracionales con uno o más miembros afectados de TDAH. A los participantes se les aplicó una entrevista psiquiátrica estructurada internacional (CIDI) para realizar el diagnóstico de referencia de TDAH a lo largo de la vida. Los participantes cumplimentaron, además, la WURS. Se hicieron análisis de factores exploratorios y confirmatorios para establecer las dimensiones del fenotipo de la conducta del TDAH. Resultados. Se encontró una estructura factorial de cuatro dimensiones que midieron descontrol conductual, hiperactividad, inatención y ansiedad, que explicaron el 60% de la variabilidad total. Conclusión. El fenotipo conductual de los adultos de familias antioqueñas con TDAH está formado por cuatro dimensiones, que podrían utilizarse en futuros análisis de heredabilidad y ligamiento (AU)
Introduction. The Wender-Utah Rating Scale (WURS) has been used for retrospective screening of attention deficit hyperactivity disorders (ADHD) symptoms and its comorbidities. Aim. To establish the ADHD behavioral phenotype dimensions of adults from 140 Antioquian families with genetic segregation for ADHD diagnosis, using the WURS Spanish version. Subjects and methods. 392 adults from both genders, belonging to nuclear and multigenerational families with one or more ADHD affected members were selected. The Composite International Diagnostic Interview (CIDI) for mental disorder was administered to establish the gold standard diagnosis of ADHD through the long life. All participants fulfill the WURS. Exploratory and confirmatory factor analyses were done to determine the behavioral dimensions of the ADHD phenotype. Results. A factor structure of four dimensions was derived, measuring behavioral decontrol, hyperactivity, inattention and anxiety, and which explained the 60% of the total variance. Conclusions. The behavioral adult ADHD phenotype in the Antioquian families was conformed by four dimensions, which could be used in heritability and linkage future studies(AU)
