Reliability, validity, and utility of instruments for self-report and informant report concerning symptoms of ADHD in adult patients.

OBJECTIVE: To study the correlation between symptoms of ADHD in adults, obtained with different methods and from different sources. METHOD: Information was obtained from 120 adults with ADHD, their partners, and their parents, using the ADHD Rating Scale, the Conners' Adult ADHD Rating Scales (CAARS), the Brown Attention-Deficit Disorder Scale (BADDS), and the structured interview Diagnostic Interview Schedule-IV, section L (DIS-L). RESULTS: All self-report rating scales can be used to assess ADHD symptoms in clinical samples of adults. The BADDS and the ADHD Rating Scale proved best in predicting the clinical diagnosis. The DSM-IV factors, originally developed for children, achieve lower patient-informant agreement than the other factors. CONCLUSION: Adults with ADHD appear to be the best informants with regard to their symptoms but tend to underreport the severity of their symptoms. Informant report may be used to get additional information on symptoms and impairment.

Possible confusion between primary hypersomnia and adult attention-deficit/hyperactivity disorder.

We explored the possibility of diagnostic confusion between hypersomnias of central origin (narcolepsy and idiopathic hypersomnia, IH) and the adult form of attention-deficit/hyperactivity disorder (ADHD). We included 67 patients with narcolepsy, 7 with IH and 61 with ADHD. All patients completed the Epworth Sleepiness Scale and the ADHD Rating Scale. We found that 18.9% of the hypersomnia patients fulfilled the self-reported criteria for ADHD in adulthood, compared with 77% of the ADHD patients. A score > or =12 on the Epworth Sleepiness Scale (usually regarded to indicate excessive daytime sleepiness) was found in 37.7% of the ADHD patients compared 95.9% of the hypersomnia patients. In ADHD patients, inattention scores correlated with the excessive daytime sleepiness score. We conclude that one should be aware of possible diagnostic confusion between narcolepsy or IH and adult ADHD when using self-report questionnaires. The high percentage of symptom overlap found in our study raises questions about possible misdiagnosing of both conditions, comorbidity with sleep problems in adult ADHD, and the validation of the used scales. It remains unclear whether our findings indicate pathophysiological overlap.