Abstract: Objective To compare the similarities and differences in the diagnosis of children's attention deficit hyperactivity disorder (ADHD) between Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-Ⅳ) and fifth edition (DSM-5), so as to evaluate the clinical efficacy. Methods From November 2013 to March 2014, all children suspected with ADHD who visited the developmental behavioral pediatric ADHD clinic of Shanghai Children's Medical Center were selected.All children were diagnosed according to the diagnostic criteria of DSM-Ⅳ and DSM-5, and were divided into three subtypes of attention deficit type, hyperactivity/impulse type and mixed type ADHD according to their symptoms.The clinical efficacy between the two methods was compared. Result The diagnostic rates of all children suspected with ADHD and the subtypes of ADHD between DSM-Ⅳ and DSM-5 were highly consistent, and the positive rate of diagnosis had no significant difference (χ²=0.881,P=0.076). Conclusions DSM-5 is highly consistent with DSM-Ⅳ in diagnosing each type of ADHD.And DSM-5 is more appropriate for diagnosing ADHD by specifying the items and ages.

Key words: children, attention and deficit hyperactive disorder, DSM-Ⅳ, DSM-5

摘要： 目的 比较美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)和第5版(DSM-5)在诊断儿童注意缺陷多动障碍(ADHD)上的异同,评价临床应用效果。方法 收集2013年11月-2014年3月到上海儿童医学中心发育行为儿科多动症门诊就诊的所有疑似ADHD儿童。所有儿童均采用DSM-Ⅳ和DSM-5两版诊断标准进行诊断,并根据患儿症状分为注意缺陷型、多动冲动型和混合型ADHD三个亚型,比较两版诊断标准的临床效果。结果 DSM-Ⅳ和DSM-5对所有疑似患儿的诊断率以及对ADHD亚型的区分有较高的符合率,且诊断阳性率差异无统计学意义(χ²=0.881,P=0.076)。结论 DSM-Ⅳ和DSM-5在诊断ADHD各型上均有较高一致性。实际工作中DSM-5通过发病年龄的改变、举例说明的描述使每个条目的实际意义更加明确,更适合临床医师对于ADHD的诊断。

关键词: 儿童, 注意缺陷多动障碍, DSM-Ⅳ, DSM-5