title: Validation of self-report instruments to assess attention deficit hyperactivity disorder symptoms in adults attending community drug and alcohol services.
abstract: 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.
  
  
  CONCLUSIONS
  : The symptoms of ADHD in adults can be reliably assessed by self-report instruments.
authors.affiliation: 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.
authors.forename: Jason
authors.initials: J
authors.lastname: Luty
authors.forename: Sujaa Mary
authors.initials: SM
authors.lastname: Rajagopal Arokiadass
authors.forename: Arghya
authors.initials: A
authors.lastname: Sarkhel
authors.forename: Joby Maducolil
authors.initials: JM
authors.lastname: Easow
authors.forename: Rewant
authors.initials: R
authors.lastname: Desai
authors.forename: Om Prabha
authors.initials: OP
authors.lastname: Moorti
authors.forename: Nasser
authors.initials: N
authors.lastname: El Hindy