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Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.

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PubMed
Summary
This summary is machine-generated.

ADHD persistence in adulthood varies significantly based on reporting methods. Combining parent and self-reports with a norm-based threshold offers the most accurate assessment, with 60% showing symptom persistence.

Keywords:
Adult ADHDDSM-5diagnosis

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Area of Science:

  • Child and Adolescent Psychiatry
  • Neurodevelopmental Disorders
  • Longitudinal Research

Background:

  • Attention-Deficit/Hyperactivity Disorder (ADHD) persistence into adulthood is highly variable.
  • Existing studies report a wide range of ADHD persistence rates (5-75%).
  • The influence of assessment methodology on reported persistence rates is not well understood.

Purpose of the Study:

  • To investigate how information source, assessment method, and symptom threshold impact reported ADHD persistence rates in adulthood.
  • To identify optimal methods for assessing adult ADHD persistence.

Main Methods:

  • Longitudinal study of 579 children diagnosed with ADHD-Combined Type.
  • Adult follow-up evaluations included parent and self-reports via rating scales and structured interviews.
  • Comparison with a local normative comparison group (LNCG).

Main Results:

  • Higher persistence rates were observed with parent reports versus self-reports.
  • Structured interviews yielded higher rates than rating scales for self-reports.
  • A norm-based (NB) threshold of 4 symptoms resulted in higher rates than DSM criteria.
  • Receiver-Operating Characteristics (ROC) analysis indicated optimal sensitivity and specificity with combined parent/self-reports on rating scales and a NB threshold.

Conclusions:

  • The interview format enhances young adult self-reporting when parental input is unavailable.
  • Combining parent and self-reports from rating scales with an 'or' rule and NB threshold balances sensitivity and specificity.
  • Using this optimized definition, 60% of the ADHD group exhibited symptom persistence, and 41% met criteria for both symptoms and impairment in adulthood.