Correspondence between DSM-III-R and DSM-IV attention- deficit/hyperactivity disorder

Objective: To evaluate the correspondence between DSM-III-R and DSM-IV definitions of attention-deficit/hyperactivity disorder (ADHD) in clinically referred children. Results of the field trials led to the hypothesis that there would be a strong correspondence between DSM-III-R and DSM-IV subtypes. Method: The sample consisted of all children and adolescents consecutively referred to a pediatric psychopharmacology clinic (N = 405). Children were comprehensively evaluated with structured diagnostic interviews assessing both DSM-III-R and DSM-IV ADHD. DSM-III-R symptoms were used to approximate DSM-IV subtypes. Kappa statistics and conditional probabilities were used to examine the correspondence between DSM-III-R and DSM-IV ADHD. Results: Ninety-three percent of children who received a DSMIII-R diagnosis of ADHD also received a DSM-IV ADHD diagnosis. The κ coefficient assessing the agreement between DSM-III-R and DSM-IV ADHD was .73 (Z = 14.6, p < .0001). The κ coefficient assessing the agreement between the DSM-III-R- approximated subtypes and the actual DSM-IV subtypes was .71 (z = 15, p < .0001). Conclusion: These results confirm previous findings and indicate that the change from DSM-III-R to DSM-IV results in minimal changes in case identification and provides support fog diagnostic continuity between the two classification systems.