The short form adult attention deficit/hyperactivity self-report scale is a useful diagnostic measure.

The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Q Do the long and short forms of the attention deficit/hyperactivity disorder (ADHD) self-report scale effectively diagnose ADHD in adults? METHODS Design: Prospective diagnostic cohort study. Patients: 154 people aged 18–44 years who participated in the US National Comorbidity Survey Replication study. Participants were selected from four groups: those reporting no childhood ADHD symptoms; those reporting some childhood ADHD symptoms, but not meeting diagnostic criteria; those meeting childhood ADHD diagnostic criteria but no current symptoms; and those meeting childhood ADHD diagnostic criteria and having current symptoms. Test: The adult ADHD self-report scale (ASRS) includes 18 items based on DSM-IV Criterion A symptoms of adult ADHD. Each item asks how frequently a symptom occurred in the preceding six months rated on a four-point scale (0 = never to 4 = very often). The optimal method for scoring each symptom as present or absent was developed by selecting a cutoff that resulted in the least difference between the false positive and false negative rate for that item. The optimal method for scoring the ASRS was found to be summing the overall number of symptoms present and diagnosing those with nine or more symptoms as having ADHD. Stepwise logistic regression was used to develop the optimal 6-item short form ASRS from the 18-item version. Interviewers administered the validated diagnostic interviews followed by the ASRS. Diagnostic standard: All participants were assessed with the semistructured clinical ADHD rating scale (ADHD-RS) and the semistructured clinical interview for recent DSM-IV adult ADHD. Diagnosis of adult ADHD was made if participants had more than one ADHD Criterion A symptom before 7 years of age, clinically significant impairment in one or more areas of living, and some impairment in two or more areas of living during the previous six months plus more than five symptoms of either hyperactivity-impulsivity or inattention (DSM-IV). Outcomes: Sensitivity and specificity; overall agreement between ASRS and the diagnostic standard; symptom concordance (Cohen's k) between ASRS and clinical symptom ratings. Using the optimal ASRS scoring method the 18-item ASRS had a sensitivity of 56.3%, a specificity of 98.3%, and a symptom concordance of 0.6. The ASRS classification (ADHD present or absent) agreed with the clinical diagnosis in 96.2% of participants. However, the short (6-item) version of the ASRS showed greater sensitivity (68.7%), specificity (99.5%), and symptom concordance …