Assessing the diagnostic accuracy of the identification of hyperkinetic disorders following the introduction of government guidelines in England

被引：14
作者：
Foreman D.M. [1 ,2 ]
Ford T. [3 ]
机构：
[1] Department of Child and Adolescent Psychiatry, Institute of Psychiatry at the Maudsley, King's College London, London SE5 8AF, De Crespigny Park
[2] Department of Health and Social Services, Isle of Man
[3] Peninsula College of Medicine and Dentistry, Plymouth PL6 8BU, Tamar Science Park, Research Way
来源：
Child and Adolescent Psychiatry and Mental Health | / 2卷 / 1期
基金：
英国医学研究理事会;
关键词：
Attention Deficit Hyperactivity Disorder; Secondary Care; Discordant Case; Hyperkinetic Disorder; Attention Deficit Hyperactivity Disorder Diagnosis;
D O I：
10.1186/1753-2000-2-32
中图分类号：
学科分类号：
摘要：
Background: Previous studies have suggested that both underdiagnosis and overdiagnosis routinely occur in ADHD and hyperkinesis (hyperkinetic disorders). England has introduced governmental guidelines for these disorders' detection and treatment, but there has been no study on clinical diagnostic accuracy under such a regime. Methods: All open cases in three Child and Adolescent Mental Health Services (CAMHS) in the South East of England were assessed for accuracy in the detection of hyperkinetic disorders, using a two-stage process employing the Strengths and Difficulties Questionnaire (SDQ) for screening, with the cut-off between "unlikely" and "possible" as the threshold for identification, and the Development And Well-Being Assessment (DAWBA) as a valid and reliable standard. Results: 502 cases were collected. Their mean age 11 years (std dev 3 y); 59% were clinically diagnosed as having a hyperkinetic disorder including ADHD. Clinicians had missed two diagnoses of hyperkinesis and six of ADHD. The only 'false positive' case was one that had become asymptomatic on appropriate treatment. Conclusion: The identification of children with hyperkinetic disorders by three ordinary English CAMHS teams appears now to be generally consistent with that of a validated, standardised assessment. It seems likely that this reflects the impact of Governmental guidelines, which could therefore be an appropriate tool to ensure consistent accurate diagnosis internationally. © 2008 Foreman and Ford; licensee BioMed Central Ltd.
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