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The validity of the DSM-IV subtypes of attention-deficit/hyperactivity disorder
Article first published online: 26 APR 2005
Australian and New Zealand Journal of Psychiatry
Volume 39, Issue 5, pages 344–353, May 2005
How to Cite
Woo, B. S. C. and Rey, J. M. (2005), The validity of the DSM-IV subtypes of attention-deficit/hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 39: 344–353. doi: 10.1111/j.1440-1614.2005.01580.x
Joseph M. Rey, Professor of Child & Adolescent Psychiatry
University of Sydney, and, Director, Child and Adolescent Mental Health Services, Northern Sydney Health, Sydney, Australia
- Issue published online: 26 APR 2005
- Article first published online: 26 APR 2005
- Received 29 April 2004; revised 24 August 2004; accepted 20 October 2004.
- ADHD subtypes;
Objective: To examine the validity of the three subtypes of ADHD defined by DSM-IV.
Method: Studies published in English were identified through searches of literature databases.
Results: Estimates of the prevalence of ADHD have increased as a result of the introduction of DSM-IV criteria. Factor analytical and genetic studies provide some support for the validity of the distinction between the three subtypes. However, diagnosis of the combined subtype seems more reliable than the other two subtypes, although reliability is largely unknown for the latter. The hyperactive-impulsive subtype, the least common, differs from the other two subtypes in age distribution, association with other factors and neuropsychological parameters. Almost all treatment trials are based on participants with the combined type.
Conclusion: Data supporting the validity of the inattentive and hyperactive-impulsive subtypes of ADHD a decade after the publication of DSM-IV are still scarce. Given that inattention is the hypothesized core ADHD symptom, it remains to be demonstrated that hyperactive-impulsive children who are not inattentive have the same condition. One of the main research deficits refers to data on treatment of the inattentive and hyperactive-impulsive subtypes.