Since publication of DSM-IV in 1994, the prevalence of parent-reported diagnosed attentiondeficit/hyperactivity disorder (ADHD) has tripled to more than 10% of children. Although it is hard to know for sure whether ADHD is overdiagnosed, underdiagnosed, or misdiagnosed, it is argued that ADHD is especially prone to diagnostic inflation and overdiagnosis. Therefore, we propose a model of stepped diagnosis for childhood ADHD, which may reduce overdiagnosis without risking undertreatment. Calling attention to stepped diagnosis and formalizing the steps may improve its application in clinical practice. (Journal of Psychiatric Practice 2014;20:169–177)
BATSTRA: Department of Special Needs Education and Child Care, University of Groningen, The Netherlands; NIEWEG: Lentis Psychiatric Institute, Groningen; PIJL: University of Groningen and Norwegian University of Science and Technology, Trondheim, Norway; VAN TOL and HADDERS-ALGRA: University Medical Center, University of Groningen.
The authors declare no conflicts of interest.
Please send correspondence to: Laura Batstra, PhD, Department of Special Needs Education and Child Care, Faculty of Behavioral and Social Sciences, University of Groningen, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands. email@example.com