The authors note that few studies of ADHD prevalence have used population-based samples, multiple informants, and Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria. Moreover, children who are asymptomatic while receiving ADHD medication often have been misclassified. The authors screened 7,587 children for ADHD. Teachers of 81% of the children completed a DSM-IV checklist. The authors interviewed parents using a structured interview (DISC). Of these, 72% participated. Parent and teacher ratings were combined to determine ADHD status. The authors estimated the proportion of cases attributable to other conditions. The authors reported 15.5% of the sample met DSM- (4th ed.; text rev., DSM-IV-TR) criteria for ADHD (95% CI [14.6%, 16.4%]); 42% of cases reported no previous diagnosis. With additional information, other conditions explained 9% of cases. The authors concluded that the prevalence of ADHD in this population-based sample was considerably higher than 3% to 7%. The authors suggested that to compare study results, the DSM criteria need standardization.
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