[ADHD screening in alcohol dependent subjects : Psychometric characteristics of ADHD self-report scale and Wender Utah Rating Scale short form].
ADHS-Screening bei Alkoholabhängigen : Psychometrische Eigenschaften der ADHS-Selbstbeurteilungsskala (ADHS-SB) und der Wender-Utah-Rating-Scale Kurzform (WURS‑k).
ADHD
Addiction
Adults
Alcohol
Questionnaire
Screening
Journal
Der Nervenarzt
ISSN: 1433-0407
Titre abrégé: Nervenarzt
Pays: Germany
ID NLM: 0400773
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
pubmed:
13
4
2019
medline:
21
11
2019
entrez:
13
4
2019
Statut:
ppublish
Résumé
Routine screening using self report questionnaires for attention deficit/hyperactivity disorder (ADHD) in patients with alcohol use disorder is recommended due to its high prevalence and the time-consuming and demanding diagnostic assessment. The psychometric properties of such self-report instruments have hardly been investigated in this patient group. The performance of the ADHD self-report scale (ADHD-SR) and the German short form of the Wender Utah Rating Scale (WURS-k) was determined in 402 patients with alcohol dependence during long-term residential weaning treatment. The diagnosis of adult ADHD had been confirmed in 85 of these patients using an extensive, standardized diagnostic procedure. The ADHD-SR at a cut-off ≥15 showed the best psychometric properties (sensitivity 75.3%, specificity 94.0%, positive predictive value, PPV 77.1%, negative predictive value, NPV 93.4%). The results of the WURS-k were unsatisfactory at the established cut-off ≥30 and also at lower cut-offs with more false positive screening results compared to the ADHD-SR. The combination of both instruments (ADHD-SR ≥ 15 and/or WURS-k ≥ 30) increased sensitivity (86.9%) albeit at the expense of a higher rate of false positive screening results (specificity 87.7%, PPV 65.2%). The ADHD-SR is a suitable instrument for routine screening of ADHD in alcohol dependent patients. To improve sensitivity, a lower cut-off (≥15) should be applied. The WURS-k as a single screening instrument cannot be recommended in alcohol dependent patients. If a higher sensitivity is desired, a combination of ADHD-SR and WURS-k is feasible.
Sections du résumé
BACKGROUND
BACKGROUND
Routine screening using self report questionnaires for attention deficit/hyperactivity disorder (ADHD) in patients with alcohol use disorder is recommended due to its high prevalence and the time-consuming and demanding diagnostic assessment. The psychometric properties of such self-report instruments have hardly been investigated in this patient group.
METHODS
METHODS
The performance of the ADHD self-report scale (ADHD-SR) and the German short form of the Wender Utah Rating Scale (WURS-k) was determined in 402 patients with alcohol dependence during long-term residential weaning treatment. The diagnosis of adult ADHD had been confirmed in 85 of these patients using an extensive, standardized diagnostic procedure.
RESULTS
RESULTS
The ADHD-SR at a cut-off ≥15 showed the best psychometric properties (sensitivity 75.3%, specificity 94.0%, positive predictive value, PPV 77.1%, negative predictive value, NPV 93.4%). The results of the WURS-k were unsatisfactory at the established cut-off ≥30 and also at lower cut-offs with more false positive screening results compared to the ADHD-SR. The combination of both instruments (ADHD-SR ≥ 15 and/or WURS-k ≥ 30) increased sensitivity (86.9%) albeit at the expense of a higher rate of false positive screening results (specificity 87.7%, PPV 65.2%).
CONCLUSION
CONCLUSIONS
The ADHD-SR is a suitable instrument for routine screening of ADHD in alcohol dependent patients. To improve sensitivity, a lower cut-off (≥15) should be applied. The WURS-k as a single screening instrument cannot be recommended in alcohol dependent patients. If a higher sensitivity is desired, a combination of ADHD-SR and WURS-k is feasible.
Identifiants
pubmed: 30976828
doi: 10.1007/s00115-019-0706-6
pii: 10.1007/s00115-019-0706-6
doi:
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
1156-1161Références
Nervenarzt. 2018 Nov;89(11):1287-1293
pubmed: 29916032
Biochem Med (Zagreb). 2012;22(3):276-82
pubmed: 23092060
J Consult Clin Psychol. 2012 Dec;80(6):1052-1061
pubmed: 22774792
Drug Alcohol Depend. 2012 Apr 1;122(1-2):11-9
pubmed: 22209385
Eur Addict Res. 2018;24(1):43-51
pubmed: 29510390
Drug Alcohol Depend. 2019 Feb 1;195:52-58
pubmed: 30583265
Addict Behav. 2008 Sep;33(9):1199-207
pubmed: 18558465
Am J Psychiatry. 1993 Jun;150(6):885-90
pubmed: 8494063
Psychiatr Q. 2018 Jun;89(2):505-510
pubmed: 29270886
J Clin Psychiatry. 2012 Nov;73(11):e1372-8
pubmed: 23218166
Nervenarzt. 2004 Sep;75(9):888-95
pubmed: 15378249
Atten Defic Hyperact Disord. 2017 Mar;9(1):47-65
pubmed: 27866355
Curr Opin Psychiatry. 2011 Jul;24(4):280-5
pubmed: 21483267
J Atten Disord. 2015 Apr;19(4):328-34
pubmed: 24743975
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Jul;57(7):820-9
pubmed: 24950831
Addict Behav. 2004 Dec;29(9):1875-82
pubmed: 15530732
Drug Alcohol Depend. 2013 Oct 1;132(3):587-96
pubmed: 23660242
PLoS One. 2015 Nov 03;10(11):e0141342
pubmed: 26529403
J Atten Disord. 2018 Jan 1;:1087054717750272
pubmed: 29308693
Eur Psychiatry. 2012 Jul;27(5):314-20
pubmed: 22112307
Clin Psychol Rev. 2011 Apr;31(3):328-41
pubmed: 21382538
J Atten Disord. 2019 Aug;23(10):1119-1125
pubmed: 27138328
Addiction. 2016 Oct;111(10):1867-78
pubmed: 27061514
Clin Child Fam Psychol Rev. 2007 Dec;10(4):335-51
pubmed: 17902055
Nervenarzt. 2003 Nov;74(11):987-93
pubmed: 14598035
J Clin Psychiatry. 2007 Jul;68(7):e18
pubmed: 17685729