Abstract
The diagnosis of attention-deficit hyperactivity disorder (ADHD) in adults is a complex procedure which should include retrospective assessment of childhood ADHD symptoms either by patient recall or third party information, diagnostic criteria according to DSM-IV, current adult ADHD psychopathology including symptom severity and pervasiveness, functional impairment, quality of life and comorbidity. In order to obtain a systematic database for the diagnosis and evaluation of the course ADHD rating scales can be very useful. This article reviews rating instruments that have found general acceptance.
The Wender-Utah Rating Scale (WURS) and the Childhood Symptoms Scale by Barkley and Murphy try to make a retrospective assessment of childhood ADHD symptoms. The Connors Adult ADHD Rating Scales (CAARS), the Current Symptoms Scales by Barkley and Murphy (CSS), the Adult Self Report Scale (ASRS) by Adler et al. and Kessler et al. or the Attention Deficit Hyperactivity Disorder—Self Report Scale (ADHD-SR by Rösler et al.) are self report rating scales focusing mainly on the DSM-IV criteria. The CAARS and the CSS have other report forms too. The Brown ADD Rating Scale (Brown ADD-RS) and the Attention Deficit Hyperactivity Disorder-Other Report Scale (ADHD-OR by Rösler et al.) are instruments for use by clinicians or significant others. Both self rating scales and observer report scales quantify the ADHD symptoms by use of a Likert scale mostly ranging from 0 to 3. This makes the instruments useful to follow the course of the disease quantitatively. Comprehensive diagnostic interviews not only evaluate diagnostic criteria, but also assess different psychopathological syndrome scores, functional disability measures, indices of pervasiveness and information about comorbid disorders. The most comprehensive procedures are the Brown ADD Diagnostic Form and the Adult Interview (AI) by Barkley and Murphy. An instrument of particular interest is the Wender Reimherr Interview (WRI) which follows a diagnostic algorithm different from DSM-IV. The interview contains only items delineated from adult psychopathology and not derived from symptoms originally designed for use in children.
Other instruments focus on functional impairment, quality of life, comorbid disorders, gender effects and specific psychopathological models.
Similar content being viewed by others
References
Adler L, Kessler R, Spencer T (2003a) Adult Self Report Scale, ASRS-V1.1 Screener. World Health Organization, New York
Adler L, Spencer T, Biederman J (2003b) Adult ADHD Investigator Symptom Rating Scale. New York University School of Medicine, New York
Adler L, Kelsey D, Dietrich AP, Reimherr FW, Sangal BR et al. (2004) Quality-of-life assessment in Atomoxetine-treated adult ADHD patients. APA, New York
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. APA, Washington DC
Angermeyer MC, Kilian R, Matschinger H (2000) WHOQOL-100 und WHOQOL–BREF. Hogrefe, Göttingen
Barkley RA (2002) Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. J Clin Psychiat 63 (Suppl 12):10–15
Barkley RA, Murphy KR (1998) Attention-deficit hyperactivity disorder. A clinical workbook Guilford, New York
Barkley RA, Fischer M, Smallish L, Fletcher K (2004) Young adult follow-up of hyperactive children: Antisocial activities and drug use. J Child Psychol Psychiat 45:195–211
Biederman J (2005) Psychiatric and functional outcome of adolescent females with ADHD: A large, controlled, five-year longitudinal follow-up study. APA, Atlanta
Brown TE (1996) Brown Attention-Deficit Disorder Scales for Adolescents and Adults. Manual. The Psychological Corporation, San Antonio
Chang HL, Chuang HY (2000) Adolescent hyperactivity and general psychopathology. Psychiatry Clin Neurosci 54:139–146
Conners CK (1996) Rating scales in attention-deficit/hyperactivity disorder:Use in assessment and treatment monitoring. J Clin Psychiat 59 (Suppl 7):24–30
Conners CK, Ehrhard D, Sparrow D (1999) CAARS Adult ADHD Rating Scales. MHS, New York
DuPaul G, Power T, Anastopoulos A, Reid R (1998) ADHD Rating Scale. IV: Checklist, norms, and clinical interpretation. Guilford, New York
Epstein J, Johnson DE, Conners CK (2001) Conners’ Adult ADHD Diagnostic Interview for DSM-IV (CAADID). MHS, New York
Faraone S (2005a) Functional impairments in adult ADHD: Implications for diagnosis. APA, Atlanta
Faraone S (2005b) The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder. Eur Child Adolesc Psychiat 14:1–10
Faraone S, Biederman J (1998) Neurobiology of attention deficit-/hyperactivity disorder. Biol Psychiatry 44:951–958
Fossatti A, Ceglie A, Aquarini E, Donati D, Donini M, Novella L, Maffei C (2001) The retrospective assessment of childhood attention deficit hyperactivity disorder in adults: reliability and validity of the Italian version of the Wender Utah Rating Scale. Compr Psychiat 42:326–336
Groß J, Blocher D, Trott GE, Rösler M (1999) Assessment of the attention-deficit/hyperactivity disorder in adults. Nervenarzt 70:20–25
Grützmacher H (2001) Unfallgefährdung bei Aufmerksamkeits- und Hyperaktivitätsstörung. Deutsches Ärzteblatt 98:1898–1900
Heiligenstein E, Conyers LM, Berns AR, Smith MA (1998) Preliminary normative data on DSM-IV attention deficit hyperactivity disorder in college students. J Am Coll Health 46:185–188
Kessler RC (2004) Prevalence of Adult ADHD in the United States: Results from the National Comorbidity Survey Replication (NCS-R) proceedings summary S 0.6. APA, New York
Kessler RC, Adler LA, Barkley R et al. (2005a) Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the National Comorbidity Survey replication. Biol Psychiatry 57:1442–1451
Kessler RC, Adler L, Ames M et al. (2005b) The World Health Organisation adult ADHD self-report scale (ASRS). A short screening scale for use in the general population. Psychol Medicine 35:245–256
Landgraf J (2005) Measuring Quality-of-Live in adults with ADHD. APA Atlanta
Leon AC, Shear K, Potera L et al. (1992) Assessing impairment in patients with panic disorder: The Sheehan Disability Scale. Soc Psychiatry Psychiatr Epidemiol 27:78–82
Mannuzza S, Gittelman T (1984) The adolescent outcome of hyperactive girls. Psychiatry Res 13:19–29
Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M (1993) Adult outcome of hyperactive boys: educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiat 50:565–576
Mannuzza S, Klein RG, Klein DF, Bessler A, Shrout P (2002) Accuracy of adult recall of childhood attention deficit hyperactivity disorder. Am J Psychiat 158:1882–1888
McGough JJ, Barkley RA (2004) Diagnostic controversies in adult attention deficit hyperactivity disorder. Am J Psychiat 161:1948–1956
Michelson D, Adler D, Spencer T et al. (2003) Atomoxetine in adults with ADHD.Two randomized,placebo-controlled studies. Biol Psychiatry 53:112–120
Milberger S, Biederman J, Faraone SV, Murphy J, Tsuang MT (1995): Attention deficit hyperactivity disorder and comorbid disorders: Issues of overlapping symptoms. Am J Psychiat 152:1793–1799
Murphy P, Schachar R (2000) Use of self-ratings in the assessment of symptoms of attention deficit hyperactivity disorder in adults. Am J Psychiatry 157:1156–1159
Murphy K, Barkley RA (1996) Prevalence of DSM-IV symptoms of ADHD in adult licensed drivers: Implications for clinical diagnosis. J Attention Disorders 1:147–161
Murphy KR, Adler LA (2004) Assessing attention-deficit/hyperactivity disorders in adults: Focus on rating scales. J Clin Psychiatry 65 (Suppl 3):12–17
Nadeau KG, Quinn P (2005) ADHD Self-Rating Scale for Women. Download www.adhs.ch
Pliszka S (1998) Comorbidity of attention deficit hyperactivity disorder with psychiatric disorder: an overview. J Clin Psychiat 59 (Suppl 7):50–58
Quinn PQ (2005) Treating adolescent girls and women with ADHD: Gender-specific issues. J Clin Psychol 60:579–587
Reimherr F (2004) The Wender Reimherr Interview. Personal Communication
Reimherr FW, Marchant BK, Strong RE, Adler L, Spencer TJ, West SA, Soni P (2005) Emotional dysregulation in adult ADHD and response to atomoxetine. Biol Psychiatry 58:125–131
Retz-Junginger P, Retz W, Blocher D et al. (2002) Wender Utah rating scale. The short-version for the assessment of the attention-deficit hyperactivity disorder (in German). Nervenarzt 73:830–838
Retz-Junginger P, Retz W, Blocher D, Stieglitz RD, Supprian T, Wender PH, Rösler M (2003) Reliability and validity of the German short version of the Wender-Utah Rating Scale for the retrospective assessment of attention-deficit/hyperactivity disorder (in German). Nervenarzt 74:987–993
Rodriguez Jiminez CR, Ponce AG, Monasor Sanchez R, Jimenez Gimenez M, Perez Rojo JA, Rubio Valladolid G, Jimenes Arriero MNM, Palomo Arvarez T (2001) Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention-deficit/hyperactivity disorder in childhood. Rev Neurol 33:138–1440
Rösler M, Retz W, Retz-Junginger P et al. (2004a) Tools for the diagnosis of attention-deficit/hyperactivity disorder in adults. Self-rating behaviour questionnaire and diagnostic checklist (German). Nervenarzt 75:888–895
Rösler M, Retz W, Retz-Junginger P et al. (2004b) Prevalence of attention deficit hyperactivity disorder in male young adult prison inmates. Eur Arch Psychiat Clin Neurosci 254:365–371
Rösler M, Retz-Junginger P, Stieglitz R (eds) (2006) Scales for the diagnosis of ADHD in adults. German title: Instrumente zur Diagnostik der ADHS bei Erwachsenen. Hogrefe, Göttingen (in preparation)
Sheehan DV (1983) The anxiety disease. Scribner, New York
Stein MA, Sandoval R, Szunowski E, Roizen N, Reinecke MA, Blondis TA, Klein Z (1995) Psychometric characteristics of the Wender Utah Rating Scale (WURS)): reliability and factor structure for men and women. Psychopharmacol Bull 31:425–433
Stieglitz RD, Freyberger H (2001) Selbstbeurteilungsverfahren. In: Stieglitz RD, Baumann U, Freyberger HJ (eds) Psychodiagnostik in Klinischer Psychologie, Psychiatrie, Psychotherapie. Thieme, Stuttgart
Ward MF, Wender PH, Reimherr FW (1993) The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 150:885–890
Weiss G, Hechtman LT, Milroy T, Perlman (1985) Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. J Am Acad Child Psychiat 24:211–220
Weiss M (2005) Functional impairment in adults with ADHD. APA, Atlanta
Wender PH (1995): Attention-deficit hyperactivity disorder in adults. Oxford University Press, Oxford New York
Wender P (2004) Wender Reimherr Interview.Personal Communication
Weyandt L, Iwaszuk W, Fulton K, Ollerton M, Beatty N, Fouts H, Schepman S,Greenlaw C (2003) The Internal Restlessness Scale: Performance of college students with and without ADHDJ Learn Disab 36:382–389
Wittchen HU, Wunderlich U, Gruschwitz S, Zaudig M (1997) Strukturiertes Klinisches Interview für DSM-IV (SKID). Hogrefe, Göttingen
Woodward L, Fergusson D,Horwood J (2000) Driving outcomes of young people with attentional difficulties in adolescence. J Am Acad Child Adolesc Psychiatry 39:627–634
World Health Organization (1993) Tenth Revision of the International Classification of Diseases, Chapter V: Mental and Behavioural Disorders: Diagnostic Criteria for Research. Huber, Bern
Ziegler E, Blocher D, Groß J, Rösler M (2003) Assessment of attention-deficit hyperactivity disorder in prison inmates (German). Recht and Psychiatrie 21:17–21
Author information
Authors and Affiliations
Corresponding author
Additional information
* The authors thank Dr. Frederick Reimherr, University of Utah, Salt Lake City, USA for critical advice.
Rights and permissions
About this article
Cite this article
Rösler, M., Retz, W., Thome, J. et al. Psychopathological rating scales for diagnostic use in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 256 (Suppl 1), i3–i11 (2006). https://doi.org/10.1007/s00406-006-1001-7
Issue Date:
DOI: https://doi.org/10.1007/s00406-006-1001-7