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Researchers develop updated adult ADHD screening scale

A recent study indicated accuracy of a version of the WHO Adult ADHD Self-Report Scale updated to include DSM-5 criteria for adult ADHD.

“Adult ADHD is associated with a high prevalence of secondary comorbid mental disorders, work impairment, accidents with injuries, and early mortality, but is typically undetected and untreated despite evidence of treatment effectiveness,” Berk Ustun, MS, of Massachusetts Institute of Technology, Cambridge, and colleagues wrote. “Accordingly, there is interest in screening for adult ADHD in primary care and workplace settings. However, published versions of existing screening scales are still calibrated to DSM-IV criteria.”

To update for DSM-5 criteria and improve the WHO Adult ADHD Self-Report Scale for screening, researchers blindly administered semistructured research diagnostic interviews for DSM-5 adult ADHD to subsamples of participants from two general population surveys. The Risk-Calibrated Supersparse Linear Integer Model was applied to the pooled data to create a DSM-5 version of the Adult ADHD Self-Report Scale, whose accuracy was then confirmed in an independent clinical sample of individuals seeking evaluation at the NYU Langone Medical Center Adult ADHD Program and primary care controls (n = 300).

Of 637 study participants, 44 household survey participants, 51 managed care participants and 173 NYU Langone participants met DSM-5 criteria for adult ADHD in the semistructured diagnostic interview.

Researchers found a six-question screening scale was optimal for distinguishing between participants with or without adult ADHD in the household and managed care cohorts.

Weighted data indicated a sensitivity of 91.4% and specificity of 96%.

When applied to the NYU Langone clinical sample, sensitivity was 91.9% and specificity was 74%.

“These fascinating findings will not only stimulate further research but could also result in less insistence on a childhood history of symptoms, perhaps even further increasing diagnostic rates,” Philip Shaw, MB, BCh, PhD, of the National Human Genome Research Institute, Bethesda, Maryland, and colleagues wrote in an accompanying editorial. “In short, as public awareness of adult ADHD increases, so too does the need for psychometrically robust screening tools both for research and to help identify those most likely to benefit from further expert assessment and treatment.” – by Amanda Oldt

Disclosure: Ustun reports no relevant financial disclosures. Shaw reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.