This paper discusses the description of attention-deficit/hyperactivity disorder (ADHD)
as a possible “disease entity” and the “disabilities” associated with it. It builds
on the nosological descriptions of ADHD from International Classification of Disease
(ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) perspectives
and introduces the distinct disability dimension from the International Classification
of Functioning, Disability and Health (ICF) perspective. It advocates for separating
assessment of disease and disability dimensions and then utilizing these constructs
jointly by using both the ICD and ICF classifications. The ICF analyzes functioning
in relation to a health condition in terms of 1) body functions and body structures,
2) activities of the person and participation of the person in society, and 3) contextual
factors such as environmental factors and personal factors. The separation of signs/symptoms
and consequences permits better understanding of the disease pathophysiology on the
one hand and the consequences (eg, its impact on the person, family, peers, school,
work, and social life) on the other hand. It will therefore enable us to better understand
the nature of ADHD because the core body functions associated with the disorder will
be better delineated. In addition, capturing environmental factors may help people
with ADHD by modifying their environments. The ICF provides a good outcome monitoring
and evaluation tool for the assessment of treatment response. As in many other disorders,
diagnosis alone is not a sufficient predictor of health care needs, utilization, costs,
or outcomes. When one adds disability as a predictor, our capacity to predict these
parameters is increased dramatically. It is therefore suggested that the ICF framework
be considered in future ADHD research activities.
Key words
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Article Info
Publication History
Accepted:
May 29,
2006
Received:
January 9,
2006
Footnotes
The views expressed in this article are solely the views of the author and do not necessarily represent the official position of the World Health Organization.
Identification
Copyright
© 2007 Ambulatory Pediatric Association. Published by Elsevier Inc. All rights reserved.
