title: Self-report of ADHD shows limited agreement with objective markers of persistence and remittance.
abstract: A controversial issue is whether self-report of symptoms and impairment is sufficient for diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adolescents and adults in the absence of other informants, such as parents. The present study investigated how well self-report is reflected by cognitive-neurophysiological and actigraph measures, which we have previously shown to discriminate between ADHD persisters, remitters and controls using parent-report (Cheung et al., 2015; Brit J Psychiat http://dx.doi.org/10.1192/bjp.bp.114.145185).
  
  
  
  Parent- and self-reported ADHD symptoms and impairment, together with cognitive, electroencephalogram (EEG) frequency, event-related potential (ERP) and actigraph measures were obtained from 108 adolescents and young adults with childhood ADHD and 167 controls.
  
  
  
  Participants reported lower levels of ADHD symptoms and impairments than parents (p < 0.05) and the ADHD persistence rate based on self-report was low at 44%, compared to the persistence rate of 79% previously reported based on parent-report. Regression analyses showed that the objective measures distinguished poorly between ADHD persistent and remittent groups based on self-report, in contrast to findings based on parent-report (Cheung et al., 2015), although the measures differentiated well between ADHD persisters and controls. Correlation analyses revealed that self-reported impairment significantly correlated with fewer of the objective measures, despite parent- and self-reported symptoms showing similar correlations with the measures.
  
  
  
  The findings show that self-reported ADHD outcome is not as well reflected by cognitive-neurophysiological and movement correlates as we previously found for parent-reported ADHD.
authors.affiliation: King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. Electronic address: ebba.du_rietz@kcl.ac.uk.
authors.forename: Ebba
authors.initials: E
authors.lastname: Du Rietz
authors.affiliation: Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, 32 Torrington Square, London WC1E 7JL, United Kingdom. Electronic address: celeste.cheung@kcl.ac.uk.
authors.forename: Celeste H M
authors.initials: CH
authors.lastname: Cheung
authors.affiliation: King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. Electronic address: grainne.mcloughlin@kcl.ac.uk.
authors.forename: Gráinne
authors.initials: G
authors.lastname: McLoughlin
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Square J5, 68159 Mannheim, Germany; Department of Child and Adolescent Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Winterthurerstr. 190, 8057 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Winterthurerstr. 190, Y17 H03, 8057 Zurich, Switzerland. Electronic address: brandeis@kjpd.uzh.ch.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brandeis
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Square J5, 68159 Mannheim, Germany. Electronic address: tobias.banaschewski@zi-mannheim.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Banaschewski
authors.affiliation: King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. Electronic address: philip.asherson@kcl.ac.uk.
authors.forename: Philip
authors.initials: P
authors.lastname: Asherson
authors.affiliation: King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. Electronic address: jonna.kuntsi@kcl.ac.uk.
authors.forename: Jonna
authors.initials: J
authors.lastname: Kuntsi
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D003265:Contingent Negative Variation / Q000502:physiology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009483:Neuropsychological Tests; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D057566:Self Report; D012720:Severity of Illness Index; D055815:Young Adult
keywords: ADHD; Actigraph; Cognitive; EEG; Persistence; Self-report