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Validation of Self-Report Instruments to Assess Attention Deficit Hyperactivity Disorder Symptoms in Adults Attending Community Drug and Alcohol Services

Luty, Jason PhD, MRCPsych; Rajagopal Arokiadass, Sujaa Mary MBBS, MRCPsych; Sarkhel, Arghya MBBS, DPM, MRCPsych, MSc; Easow, Joby Maducolil MBBS; Desai, Rewant MBBS, MRCPsych; Moorti, Om Prabha MB, BS, DCP, MRCPsych; El Hindy, Nasser MB, BCh

doi: 10.1097/ADM.0b013e31819343d0
Original Article

Background: Symptoms of attention deficit disorder of predominantly inattentive, predominantly hyperactive-impulsive subtype, or combined (hereafter referred to as ADHD), may persist into adulthood, although the diagnosis in adults remains controversial. The study aimed to validate self-report instruments for assessment of adult ADHD in a sample of treatment-seeking adults attending community drug and alcohol teams.

Methods: Adult patients attending 3 National Health Service (NHS) community drug and alcohol teams in England completed several self-report instruments for assessment of adult ADHD symptoms, and a diagnosis of adult ADHD was determined using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria with an interview with both the patient and an informant.

Results: One hundred seven subjects completed the project. Thirty-nine percent of subjects had an undisputed diagnosis of adult ADHD. The most accurate self-report instrument for diagnosis of adult ADHD was the Connors Adult ADHD Rating Scale Self-report Long version—a cutoff of 91 of 198 gave a sensitivity of 97% and specificity of 83%. Analysis of the WHO Adult ADHD Self-report Screener confirmed the optimal recommended cutoff as 12 of 13 giving 89% sensitivity and 83% specificity for adult ADHD against diagnostic interview. Although the Wender Utah adult ADHD scale is designed to retrospectively assess symptoms of ADHD in childhood it gave a sensitivity of 88% and specificity of 70% for diagnosis of ADHD in adults.

Conclusion: The symptoms of ADHD in adults can be reliably assessed by self-report instruments.

From the Department of General Psychiatry (JL, SMRA, JME, RD, OPM, NEH), South Essex Partnership NHS Foundation Trust, Wickford, Essex; and Department of General Psychiatry (AS), Imperial College, London, United Kingdom.

Received for publication July 31, 2008; accepted October 22, 2008.

Send correspondence and reprint requests to Jason Luty, PhD, MRCPsych, Consultant in Addictions Psychiatry, South Essex Partnership NHS Trust, Honorary Consultant in Addictions Psychiatry, Cambridge and Peterborough Mental Health NHS Trust, The Taylor Centre, Queensway House, Essex Street, Southend on Sea, Essex SS1 2RB. e-mail:

© 2009 American Society of Addiction Medicine