Elsevier

Comprehensive Psychiatry

Volume 45, Issue 3, May–June 2004, Pages 175-183
Comprehensive Psychiatry

Screening and diagnostic utility of self-report attention deficit hyperactivity disorder scales in adults

https://doi.org/10.1016/j.comppsych.2004.02.006Get rights and content

Abstract

Attention deficit hyperactivity disorder (ADHD) in adults is associated with significant social, legal, occupational, and psychiatric difficulties. The estimated prevalence of ADHD in the adult population is between 0.3% and 5%. Recent interest in the condition in adults has been accompanied by the appearance of a number of readily available scales for screening adults and aiding in the diagnosis of ADHD in this age group. However, there are few published data on the validity and reliability of such measures. We examined the diagnostic and screening utility of three ADHD scales (Adult Rating Scale [ARS], Attention-Deficit Scales for Adults [ADSA], and Symptom Inventory for ADHD) in 82 adults presenting for ADHD evaluation. All three instruments were sensitive to the presence of symptoms in adults with ADHD (correctly identifying 78% to 92% of patients with ADHD), but a high proportion of individuals with non-ADHD diagnoses screened positive (incorrectly identifying between 36% and 67% of non-ADHD patients). Our results suggest that the use of such measures for screening and as an aid in diagnosis should be approached with considerable caution.

Section snippets

Participants

Eighty-two patients evaluated during 1997 to 1999 in an adult ADHD specialty clinic provided data for this study. These patients presented for evaluation based on the reputation of the clinic in the Seattle area as a university-affiliated clinic that would provide a thorough, several-hour evaluation based on self-report, review of corroborating documents (e.g., grade school report cards, performance evaluations), and interview of parents or other family members. Some patients presented to our

Results

Based on the diagnostic interview, 38 patients were identified with ADHD, and 44 received a non-ADHD principal diagnosis. Patients with ADHD were significantly younger than non-ADHD patients [34.2 v 40.3 years; t(80) = 2.80, P < .01]. Most of the patients were white, and this did not differ by diagnosis (ADHD 97.4%, non-ADHD 95.5%). A higher proportion of the non-ADHD group was male (63.6%) than the ADHD group (55.3%), but this was not a statistically significant difference. The principal

Discussion

The relatively recent recognition of ADHD as a true syndrome in adults has left researchers and clinicians eager for valid and reliable screening measures and tools to aid in the diagnosis of this population. A number of such measures have been published both commercially and in the research literature. Our own clinical experience has taught us that many adults have been told that they have ADHD based largely (and sometimes solely) on their responses to self-report indices of symptoms. Our

References (38)

  • J Biederman et al.

    Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder

    Am J Psychiatry

    (1993)
  • T Spencer et al.

    Is attention-deficit hyperactivity disorder in adults a valid disorder?

    Harv Rev Psychiatry

    (1994)
  • B.L Borland et al.

    Hyperactive boys and their brothersa 25-year follow-up study

    Arch Gen Psychiatry

    (1976)
  • S Mannuzza et al.

    Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status

    Arch Gen Psychiatry

    (1993)
  • S Mannuzza et al.

    Adult psychiatric status of hyperactive boys grown up

    Am J Psychiatry

    (1998)
  • P Roy-Byrne et al.

    Adult attention-deficit hyperactivity disorderassessment guidelines based on clinical presentation to a specialty clinic

    Compr Psychiatry

    (1997)
  • Diagnostic and Statistical Manual for Mental Disorders

    (1994)
  • R.A Barkley et al.

    Attention-Deficit Hyperactivity DisorderA Clinical Workbook

    (1998)
  • D Shaffer

    Attention deficit hyperactivity disorder in adults

    Am J Psychiatry

    (1994)
  • Cited by (0)

    View full text