Article

Psychopathological rating scales for diagnostic use in adults with attention-deficit/hyperactivity disorder (ADHD)

University Hospital of the Saarland, Neurocenter, 66421, Homburg/Saar, Germany.
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.36). 09/2006; 256 Suppl 1(Suppl 1):i3-11. DOI: 10.1007/s00406-006-1001-7
Source: PubMed

ABSTRACT The diagnosis of attention-deficit hyperactivity disorder (ADHD) in adults is a complex procedure which should include retrospective assessment of childhood ADHD symptoms either by patient recall or third party information, diagnostic criteria according to DSM-IV, current adult ADHD psychopathology including symptom severity and pervasiveness, functional impairment, quality of life and comorbidity. In order to obtain a systematic database for the diagnosis and evaluation of the course ADHD rating scales can be very useful. This article reviews rating instruments that have found general acceptance. The Wender-Utah Rating Scale (WURS) and the Childhood Symptoms Scale by Barkley and Murphy try to make a retrospective assessment of childhood ADHD symptoms. The Connors Adult ADHD Rating Scales (CAARS), the Current Symptoms Scales by Barkley and Murphy (CSS), the Adult Self Report Scale (ASRS) by Adler et al. and Kessler et al. or the Attention Deficit Hyperactivity Disorder--Self Report Scale (ADHD-SR by Rösler et al.) are self report rating scales focusing mainly on the DSM-IV criteria. The CAARS and the CSS have other report forms too. The Brown ADD Rating Scale (Brown ADD-RS) and the Attention Deficit Hyperactivity Disorder--Other Report Scale (ADHD-OR by Rösler et al.) are instruments for use by clinicians or significant others. Both self rating scales and observer report scales quantify the ADHD symptoms by use of a Likert scale mostly ranging from 0 to 3. This makes the instruments useful to follow the course of the disease quantitatively. Comprehensive diagnostic interviews not only evaluate diagnostic criteria, but also assess different psychopathological syndrome scores, functional disability measures, indices of pervasiveness and information about comorbid disorders. The most comprehensive procedures are the Brown ADD Diagnostic Form and the Adult Interview (AI) by Barkley and Murphy. An instrument of particular interest is the Wender Reimherr Interview (WRI) which follows a diagnostic algorithm different from DSM-IV. The interview contains only items delineated from adult psychopathology and not derived from symptoms originally designed for use in children. Other instruments focus on functional impairment, quality of life, comorbid disorders, gender effects and specific psychopathological models.

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Available from: Marc F Schneider, May 06, 2014
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    • "This strategy for assessing impairment was chosen to mimic approaches in clinical settings, in which clinicians tend to rely on the subject's general perception of impairment instead of on extensive evaluations of correlates of functioning. Thus, clinicians tend to assess ADHD impairment based on patient's perceptions (Rösler et al. 2006). Although the threshold for defining impairment is subjective and individual, clinicians diagnose ADHD even in cases without substantial impairment . "
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    Psychological Medicine 06/2014; 45(2):1-13. DOI:10.1017/S0033291714001470 · 5.43 Impact Factor
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    • "In particular, also assessment of childhood ADHD symptoms did not necessarily rely on third person observations in this study. However, diagnostic interviews which were primarily used in this study are the fundamental basis of every diagnostic process in adult psychiatry and it has been shown that adults present competent sources of information and that self-reports may lead to valid diagnoses in subjects with ADHD in particular (Murphy and Schachar 2000; R ö sler et al. 2006). "
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    • "All had committed felony crimes and were incarcerated for more than 2 years. ADHD syndrome and psychopathy scores were established by means of the ADHD self report scale (Rösler et al., 2006) and the PCL-SV, respectively. We found a rank correlation of 0.2 between PCL-SV and ADHD-SR mean scores, which was statistically significant (p ≤ 0.01), but clinically not meaningful. "
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