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Behav. Sci. 2018, 8(4), 37; https://doi.org/10.3390/bs8040037

Performance of the Adult ADHD Self-Report Scale-v1.1 in Adults with Major Depressive Disorder

1
Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 12 Executive Park Drive, 3rd Floor, Atlanta, GA 30329, USA
2
School of Public Health, Emory University, Atlanta, GA 30329, USA
*
Author to whom correspondence should be addressed.
Received: 26 January 2018 / Revised: 21 March 2018 / Accepted: 27 March 2018 / Published: 29 March 2018
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Abstract

Attention deficit/hyperactivity disorder (ADHD) is an under-recognized comorbid disorder among patients with mood disorders. ADHD is an independent risk factor for suicidal ideation and behavior and contributes to many aspects of impaired function in adults. Diagnosis of ADHD in Major Depressive Disorder (MDD) patients is challenging due to the overlap in cognitive symptoms between the two disorders. The ADHD Self-Report Scale, version 1.1 (ASRS-v1.1) is a widely used screening instrument for ADHD in adults but its accuracy has not been evaluated previously in treatment-seeking MDD patients. We administered the ASRS-v1.1 to 55 healthy controls and 40 adults with a primary psychiatric diagnosis of MDD who were participating in clinical research studies. ADHD diagnosis was assessed via structured interview with the adult ADHD module of the Mini International Neuropsychiatric Interview Plus version 6.0.0 (MINI) along with a psychiatrist’s assessment. Overall, full-syndrome ADHD was diagnosed in 12.5% of the MDD patients. MDD patients endorsed all 18 items of the ASRS-v1.1 more frequently than the healthy controls and the number of ASRS-v1.1 items endorsed correlated with levels of anxiety in the MDD patients. The ASRS-v1.1 demonstrated fair performance for identifying full syndrome DSM-IV ADHD diagnosis, with sensitivity 60%, specificity: 68.6%, positive predictive value 21.4%, negative predictive value 92.3% and total classification accuracy of 67.5%. Positive predictive value improved substantially when the ADHD criterion requiring symptom onset before age 7 was omitted. In adult MDD patients, a negative ASRS-v1.1 screen strongly suggests the absence of ADHD but positive screen results require careful evaluation to determine whether self-reported ADHD symptoms simply emerge from depression or whether comorbid ADHD is present. View Full-Text
Keywords: screening; comorbidity; depression; attention; cognitive impairment; anxiety screening; comorbidity; depression; attention; cognitive impairment; anxiety
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Dunlop, B.W.; Wu, R.; Helms, K. Performance of the Adult ADHD Self-Report Scale-v1.1 in Adults with Major Depressive Disorder. Behav. Sci. 2018, 8, 37.

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