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Can We Agree?

DSM vs ICD
Do we win? … or lose?

You and I, we know this thing we call ADHD.

But just who is it calling it ADHD?

Well, that’s the name given in the DSM, the Diagnostic and Statistical Manual. But it’s not the only book on all things health related.

There is …

There’s the ICD. It’s the manual that is recognized by the WHO. That’s the World Health Organization, not the British rock group.

Now we come to a little problem. You won’t find ADHD in the ICD. It’s there, sort of, just not under that name.

The WHO recognizes, through the ICD, a disorder called “hyperkinesis” and says that the reason they disagree with the concept of ADHD is that they feel that ” … it suggests the inclusion of anxious, preoccupied, or “dreamy” apathetic children whose problems are probably different.”

But that’s …

Yep. That’s the inattentive sub-type of ADHD.

Is that a problem? Well, it might be for those who have inattentive ADHD. The ICD seems quite dismissive of them, and suggests that they have other problems, though they don’t state specifically what those might be anywhere that I can find.

And stats?

Yeah, so, the current thinking in the field is that ADHD affects 15% of the population, the current diagnostic rate is suggested to be about 5 to 7 percent when diagnosed by the standards set out by the DSM.

According to ICD standards though, the rate of diagnosis for hyperkinesis is 1 to 2 percent.

Additionally …

The criteria for diagnosis via the ICD is couched in very firm language that tends to make one feel like they are being asked if they really feel that they deserve such a designation.

One is required to present at least 6 of the 8 inattentive criteria, at least 3 of the 5 hyperactive criteria, and at least 1 of the 3 impulsivity criteria.

And since there is no sub-types, all of the above must be present in order for a diagnosis to be made.

So,

What if you have one impulsivity trait, three or four hyperactive traits, and only five of the inattentive traits?

What indeed? Sorry, can’t help you. You seem to be … you know, well within the normal spectrum according to the WHO (again, not the rock band).

Or what if you had all eight inattentive criteria covered, and all three impulsivity criteria in the bag as well, but you just weren’t hyperactive? Yeah, no …

So what does this mean?

Well, in the little picture, it means that you might warrant a diagnosis of ADHD when you would be unable to acquire a diagnosis of hyperkinesis.

And remember a diagnosis is a stepping stone on the way to getting help, not a badge of honor or something worth achieving.

But in the big picture …

In the big picture it means that the world is presented with conflicting images of this disorder. It means that the detractors of this disorder are able to point and say, “See, they can’t even agree on what they say is real, why should we agree with them.”

So, maybe it’s time that the world health care providers pushed for some sort of consolidation. And maybe we need to push them to do that.

‘Cause frankly, part of our treatment should include the dissipation of stigma caused by confusion and conflicting criteria.

Healthcare definitions should not be adding to our disorder and its negative effects on our lives.

Can We Agree?

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APA Reference
Babcock, K. (2018). Can We Agree?. Psych Central. Retrieved on January 17, 2019, from https://blogs.psychcentral.com/adhd-man/2018/10/can-we-agree/

 

Last updated: 19 Oct 2018
Last reviewed: By John M. Grohol, Psy.D. on 19 Oct 2018
Published on PsychCentral.com. All rights reserved.