ADULT ATTENTION-DEFICIT HYPERACTIVITY DISORDER - ASSESSMENT GUIDELINES BASED ON CLINICAL PRESENTATION TO A SPECIALTY CLINIC

Of 143 adults presenting for attention-deficit hyperactivity disorder (ADHD) evaluation, 46 (32%) clearly met diagnostic criteria, 46 (32%) clearly did not meet diagnostic criteria, and another 51 (36%) with cu rrent ADHD-like features did not meet criteria due to either a lack of childhood history and/or complicating severe psychiatric or substance abuse comorbidity. The three groups were similar in demographics, psy chiatric diagnosis, psychiatric symptom severity, and functional impai rment. Compared with the group not meeting ADHD criteria, patients wit h ADHD had more frequent histories of learning disability in childhood , poorer reading scores on the Wide-Range Achievement Test (WRAT), poo rer scores on the Continuous Performance Test (CPT), and higher scores on the Wender-Utah Rating Scale (WURS) for ADHD. Patients in the ambi guous ADHD category had higher rates of current substance abuse than t he other two groups. While this group resembled the non-ADHD group in having a low incidence of learning disability and normal reading score s, their poor performance on the CPT and high scores on the WURS more closely resembled those of ADHD patients. These findings suggest that there are a few rating scales, testing instruments, and lifetime histo ry characteristics that help to clarify the difficult diagnostic disti nction between adult patients who do and do not have ADHD. Copyright ( C) 1997 by W.B. Saunders Company.