Screening and Diagnostic Tools
In adult patients, symptoms of ADHD can frequently overlap with those of other psychiatric comorbidities.1-4
Screening Resources for MDD, GAD, and ADHD
MDD, GAD, and ADHD are highly comorbid conditions. For patients in whom you suspect any of these conditions, consider referring to the screening resources provided.
SCREENING AND DIAGNOSTIC SCALES FOR USE WITH ADULTS
To aid physicians and psychologists in the diagnostic process, several validated behavior scales have been developed to help screen, diagnose, evaluate, and track symptoms of ADHD in adults.
These scales are not to be used as sole diagnostic tools, nor should they replace the full clinical assessment based on the DSM-5® criteria; however, they may help review and quantify symptoms.5
COMMON BEHAVIOR RATING SCALES USED IN ADULTS TO ASSESS ADHD AND MONITOR ADHD SYMPTOMS6-10
ADULT ADHD SELF-REPORT SCALE (ASRS-v1.1) SYMPTOM CHECKLIST
An 18-item scale that can be used as an initial symptom assessment to identify adults who may have ADHD6,9
- The scale has a question for each of the 18 symptom domains identified by the DSM-IV® criteria, with modifications to account for the adult presentation of ADHD symptoms6
- Measures the frequency of how often symptoms occur based on a 0 to 4 rating scale (0=never, 1=rarely, 2=sometimes, 3=often, 4=very often)9
ADULT ASRS-v1.1 SCREENER
A 6-question subset of the full 18-item ASRS-v1.1 Symptom Checklist that can be used to screen for adults who may have ADHD6,9
- Can be used as an initial self-assessment tool to identify adults who may have ADHD but it is not diagnostic in and of itself6
- The 6-question subset (Part A) of the ASRS Symptom Checklist was found to be most predictive of ADHD symptoms11
- Scoring is based on how often a symptom occurs6,7,11
ADULT ADHD CLINICAL DIAGNOSTIC SCALE (ACDS) v1.2
A diagnostic measure developed to establish the presence of current adult symptoms of ADHD8,11
- The 18-item, clinician-based, semistructured interview employs adult-specific language to ensure adequate probing of adult manifestations of ADHD symptoms8,11
- The 18 items in the scale correspond to the 18 symptoms in the DSM-IV® criteria8,11
BROWN ATTENTION-DEFICIT DISORDER RATING SCALE (BADDS) FOR ADULTS
A broad-based, 40-item rating scale providing a rating of the frequency of symptoms in many domains6
- Items represent 5 dimensions of symptoms: organizing work, sustaining attention and concentration, sustaining alertness and effort, managing frustration and other emotions, and using work memory6,9
- The scale can be used as a self-report or as a clinician-administered scale6
- Scoring is based on a 4-point frequency scale ranging from 0=never to 3=almost daily6,9
DSM-IV® and DSM-5® are registered trademarks of the American Psychiatric Association.
References: 1. Feifel D, MacDonald K. Attention-deficit/hyperactivity disorder in adults: recognition and diagnosis of this often-overlooked condition. Postgrad Med. 2008;120(3):39-47. 2. Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Prim Care Companion CNS Disord. 2014;16(3):e1-e8. 3. Kooij JJS, Huss M, Asherson P, et al. Distinguishing comorbidity and successful management of adult ADHD. J Atten Disord. 2012;16(5 suppl):3S-19S. 4. Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163(4):716-723. 5. Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894-921. 6. Adler L, Cohen J. Diagnosis and evaluation of adults with attention-deficit/hyperactivity disorder. Psychiatr Clin North Am. 2004;27(2):187-201. 7. Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005;35(2):245-256. 8. Kessler RC, Green JG, Adler LA, et al. Structure and diagnosis of adult attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2010;67(11):1168-1178. 9. Murphy K, Adler LA. Assessing attention-deficit/hyperactivity disorder in adults: focus on rating scales. J Clin Psychiatry. 2004;65(suppl 3):12-17. 10. DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretation. New York, NY: The Guilford Press; 1998. 11. Goodman DW. ADHD in adults: update for clinicians on diagnosis and assessment. Prim Psychiatry. 2009;16(11):21-30.