Validation of self-report instruments to assess attention deficit hyperactivity disorder symptoms in adults attending community drug and alcohol services.

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.