Mathias Luderer1,2, Nurcihan Kaplan-Wickel3,4, Christian Sick3,4, Agnes Richter4, Iris Reinhard5, Falk Kiefer3,6, Tillmann Weber4. 1. Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum, Goethe-Universität Frankfurt, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Deutschland. mathias.luderer@kgu.de. 2. Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland. mathias.luderer@kgu.de. 3. Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland. 4. MEDIAN Klinik Wilhelmsheim, Oppenweiler, Deutschland. 5. Abteilung Biostatistik, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland. 6. Feuerlein Centrum für Translationale Suchtmedizin, Mannheim, Deutschland.
Abstract
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: 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: 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: 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.
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: 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: 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: 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.
Authors: Margaret H Sibley; William E Pelham; Brooke S G Molina; Elizabeth M Gnagy; James G Waxmonsky; Daniel A Waschbusch; Karen J Derefinko; Brian T Wymbs; Allison C Garefino; Dara E Babinski; Aparajita B Kuriyan Journal: J Consult Clin Psychol Date: 2012-07-09
Authors: Cleo L Crunelle; Wim van den Brink; Franz Moggi; Maija Konstenius; Johan Franck; Frances R Levin; Geurt van de Glind; Zsolt Demetrovics; Corné Coetzee; Mathias Luderer; Arnt Schellekens; Frieda Matthys Journal: Eur Addict Res Date: 2018-03-06 Impact factor: 3.015
Authors: Katelijne van Emmerik-van Oortmerssen; Geurt van de Glind; Wim van den Brink; Filip Smit; Cleo L Crunelle; Marije Swets; Robert A Schoevers Journal: Drug Alcohol Depend Date: 2011-12-30 Impact factor: 4.492
Authors: Elias Dakwar; Amy Mahony; Martina Pavlicova; Andrew Glass; Daniel Brooks; John J Mariani; John Grabowski; Frances Rudnick Levin Journal: J Clin Psychiatry Date: 2012-11 Impact factor: 4.384
Authors: Albert J Arias; Joel Gelernter; Grace Chan; Roger D Weiss; Kathleen T Brady; Lindsay Farrer; Henry R Kranzler Journal: Addict Behav Date: 2008-05-13 Impact factor: 3.913