Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study.
OBJECTIVE
To provide psychometric information on the Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV (ADHD-RS-IV) in a large population of children with ADHD.


METHODS
Patients aged 6-18 years (n=1,478 in baseline analysis) were rated by 244 physicians on the ADHD-RS-IV based on a semi-structured interview with the patient's parent. Physicians additionally rated functional impairment (CGAS) and health status (CGI-S), and parents rated their child's behavioural and emotional problems (SDQ) and quality of life (CHIP-CE).


RESULTS
Inattention and hyperactivity-impulsivity as dimensions of ADHD were replicated. 3-factor solutions reflecting the ICD-10 definition, with hyperactivity, impulsivity and inattention as separate dimensions were extracted in some national sub-samples and in separate analyses for boys and younger children.Good internal consistencies, strong country effects and small effects of age were found. Based on ADHD-RS-IV, 88.5% of patients met the criteria for any ADHD diagnosis. Correlations between ADHD-RS-IV and measures of functional impairment were low but statistically significant. The correlations with SDQ and CHIP-CE scales confirm the convergent and divergent validity of ADHD-RS-IV.


CONCLUSIONS
Impressive evidence for the cross-cultural factorial validity, internal consistency as well as convergent and divergent validity of ADHD-RS-IV was found. ADHD can be assessed reliably and validly in routine care across Europe. The ICD-10 3-factor model seems to be less robust than the DSM-IV 2-factor model, but may be a good description for special populations (boys, younger children).
Döpfner
Manfred
M
Dept. of Child and Adolescent Psychiatry, University of Cologne, Robert Koch Str. 10, 50931, Köln, Germany. manfred.doepfner@uk-koeln.de
Steinhausen
Hans-Christoph
HC
Coghill
David
D
Dalsgaard
Søren
S
Poole
Lynne
L
Ralston
Stephen J
SJ
Rothenberger
Aribert
A
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D017677:Age Distribution; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D025341:Principal Component Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires / Q000592:standards*