Psychometric properties of ADHD screening and diagnostic tools in patients with severe substance use disorders

Abstract

Objective The aim of this study was to compare the performance of several tools for diagnosing ADHD in an adult population suffering from SUD, within a multi-tool diagnostic procedure. Method Eighty-two patients suffering from SUD and suspected of ADHD were referred to undergo the procedure. They were asked to complete two questionnaires: the Adult Self Report Scale (ASRS-6) and the Wender Utah Rating Scale (WURS-25) and three interviews: the Mini International Neuropsychiatric Interview (MINI-S), the Dual Diagnosis Screening Interview (DDSI) and the Diagnostich Interview Voor ADHD (DIVA-5). Their performance was compared to a consensus statement provided by trained psychiatrists and psychologists informed by all the assessments. Results All the tools showed good sensitivity (0.81-0.98), but only the DIVA-5 showed good specificity (0.88). Accordingly, the negative predictive value calculated for an assumed prevalence of ADHD of 23 % was high for all tools (0.88 - 0.99) whereas only the DIVA-5 showed a good positive predictive value (0.71). Conclusion The ASRS, the WURS, the MINI and the DDSI are thus useful screening tools among SUD patients, but the DIVA-5 seems to provide the most accurate information to ascertain ADHD diagnosis in this population. Further investigations are needed to assess the impact of prior standardized comorbidity evaluations on the accuracy of DIVA-5.