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[注意缺陷多动障碍(ADHD)与共病精神障碍:鉴别诊断中特定于ADHD的自评量表]

[Attention deficit-hyperactivity disorder (ADHD) and comorbid mental disorders : ADHD-specific self-rating scales in differential diagnostics].

作者信息

Paucke M, Stark T, Exner C, Kallweit C, Hegerl U, Strauß M

机构信息

Klinik und Poliklinik für Psychiatrie und Psychotherapie, ADHS-Sprechstunde, Universitätsklinikum Leipzig AöR, Semmelweisstr. 10, 04103, Leipzig, Deutschland.

Institut für Psychologie, Universität Leipzig, Leipzig, Deutschland.

出版信息

Nervenarzt. 2018 Nov;89(11):1287-1293. doi: 10.1007/s00115-018-0553-x.

Abstract

BACKGROUND

It is still unclear how well the established attention deficit-hyperactive disorder (ADHD)-specific rating scales can differentiate between ADHD symptoms and symptoms of other mental disorders.

METHODS

A total of 274 patients with suspected adult ADHD were extensively examined clinically and guideline-conform in an ADHD outpatient clinic. In 190 patients the diagnosis of ADHD could be made with certainty. The patients were also subsequently assessed according to the DSM IV criteria by self-rating scales on current (ADHS-SB, ASRS, CAARS) and retrospective (WURS-K) complaints. A binary logistic regression analysis was performed in order to extract from the questionnaires, which could best distinguish the diagnosis of ADHD from other mental disorders.

RESULTS

The results showed that two self-rating scales (WURS-K and ADHS-SB) were sufficient to correctly diagnose ADHD in 83% of the patients examined with a sensitivity of 94% and specificity of 56%.

CONCLUSION

The ADHD-specific self-rating scales are additionally useful for the diagnostic differentiation between ADHD-specific and other psychiatric symptoms in the clinical practice and can improve the safety of the diagnosis.

摘要

背景

目前仍不清楚既定的注意力缺陷多动障碍(ADHD)特定评定量表在区分ADHD症状与其他精神障碍症状方面的效果如何。

方法

共有274名疑似成人ADHD患者在一家ADHD门诊接受了全面的临床检查且符合诊疗指南。其中190名患者被明确诊断为ADHD。随后,患者还根据《精神疾病诊断与统计手册》第四版标准,通过自评量表对当前(ADHS - SB、ASRS、CAARS)和既往(WURS - K)的症状进行了评估。进行二元逻辑回归分析,以便从问卷中提取最能将ADHD诊断与其他精神障碍区分开来的因素。

结果

结果显示,两个自评量表(WURS - K和ADHS - SB)足以在83%的受检患者中正确诊断ADHD,灵敏度为94%,特异度为56%。

结论

ADHD特定自评量表在临床实践中对于区分ADHD特定症状与其他精神症状的诊断也很有用,并且可以提高诊断的准确性。

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