ICD-10

The International Classification of Mental and Behavioural Disorders 10th revision (ICD-10) medical classification system was developed by the World Health Organization (WHO).1 ICD-10 talks about attention-deficit hyperactivity disorder (ADHD) as hyperkinetic disorder (HKD), a term widely used in Europe and included in European clinical guidelines developed with the European Network for Hyperkinetic Disorders (EUNETHYDIS).1

  • This classification system defines HKD as a persistent and severe impairment of psychological development, characterised by "early onset; a combination of overactive, poorly modulated behaviour with marked inattention and lack of persistent task involvement; and pervasiveness, over situations and persistence over time of these behavioural characteristics"1
  • ICD-10 notes that characteristic problems of lack of persistence, moving between activities without completion, and disorganised and excessive activity always arise early in development, but usually continue through school years and can persist into adult life.1

For a diagnosis of HKD, ICD-10 requires evidence of both impaired attention and overactivity in more than one situation (e.g. home, classroom, clinic).1 However, deficits in persistence and attention should be diagnosed only if they are excessive for the child's age and IQ; and overactivity should be considered in the context of what is expected in the situation and by comparison with other children of the same age and IQ.1

Overview of the ICD-10 medical classification system for ADHD

  • A combination of overactive, poorly modulated behaviour with marked inattention and lack of persistent task involvement
  • Symptoms prior to six years of age and of long duration
  • Impairment present in two or more settings
  • Exclude diagnosis of anxiety disorders, mood affective disorders, pervasive developmental disorders and schizophrenia

ICD-10 states that the characteristic behaviour problems associated with HKD should be of early onset (age <6 years) and of long duration.1

  • Diagnosis of HKD may also be made in adult life using the same criteria, however, attention and activity must be judged with reference to developmentally appropriate norms.1
  • Caution is recommended in children of pre-school age and only extreme levels of hyperactivity should lead to a diagnosis in these individuals.1

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  1. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Available at: www.who.int/entity/classifications/icd/en/bluebook.pdf. Last updated 1993; 1: 1-263. Accessed March 2015.

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