Adamou Marios, Arif Muhammad, Asherson Philip, Cubbin Sally, Leaver Laurence, Sedgwick-Müller Jane, Müller-Sedgwick Ulrich, van Rensburg Kobus, Kustow James
School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom.
Adult ADHD Clinic, South West Yorkshire Partnership National Health Service (NHS) Foundation Trust, Huddersfield, United Kingdom.
Front Psychiatry. 2024 Aug 2;15:1380410. doi: 10.3389/fpsyt.2024.1380410. eCollection 2024.
Attention Deficit Hyperactivity Disorder (ADHD) frequently persists into adulthood. There are practice guidelines that outline the requirements for the assessment and treatment of adults. Nevertheless, guidelines specifying what constitutes a good quality diagnostic assessment and report and the competencies required to be a specialist assessor are lacking. This can lead to variation in the quality and reliability of adult ADHD assessments. Poor quality assessments may not be accepted as valid indicators of the presence of ADHD by other clinicians or services, resulting in wasteful re-assessments and delays in providing treatment. To address this issue the UK Adult ADHD Network (UKAAN) proposes a quality framework for adult ADHD assessments - the Adult ADHD Assessment Quality Assurance Standard (AQAS).
The co-authors agreed on five questions or themes that then guided the development of a set of consensus statements. An initial draft was reviewed and amended in an iterative process to reach a final consensus.
What constitutes a high-quality diagnostic assessment and report was agreed by consensus of the co-authors. The resulting guideline emphasises the need to evaluate impairment, describes core competencies required by the assessor and highlights the importance of linking the diagnosis to an appropriate post-diagnostic discussion. Assessments should be completed in the context of a full psychiatric and neurodevelopmental review, and need good interview skills, using a semi-structured interview with open questioning and probing to elicit real life examples of symptoms and impairments. It is recommended that 2 hours or more is required for an adequate assessment including both the diagnostic assessment and initial post-assessment discussions.
The AQAS has been developed as a practical resource to support reliable and valid diagnostic assessments of adult ADHD. It is intended to complement formal training. A secondary objective is to empower patients by providing them with evidence-based information on what to expect from an assessment and assessment report.
注意力缺陷多动障碍（ADHD）常常持续至成年期。现有实践指南概述了成人评估与治疗的要求。然而，缺乏明确高质量诊断评估及报告的构成要素以及成为专业评估者所需能力的指南。这可能导致成人ADHD评估的质量和可靠性存在差异。质量不佳的评估可能不被其他临床医生或服务机构视为ADHD存在的有效指标，从而导致重复评估的资源浪费以及治疗延误。为解决这一问题，英国成人ADHD网络（UKAAN）提出了成人ADHD评估的质量框架——成人ADHD评估质量保证标准（AQAS）。
共同作者就五个问题或主题达成一致，这些问题或主题随后指导了一组共识声明的制定。初稿经过反复审查和修订，以达成最终共识。
共同作者就高质量诊断评估及报告的构成要素达成了共识。由此产生的指南强调了评估损害的必要性，描述了评估者所需的核心能力，并突出了将诊断与适当的诊断后讨论相联系的重要性。评估应在全面的精神和神经发育评估背景下完成，需要良好的访谈技巧，采用半结构化访谈并进行开放式提问和深入探究，以引出症状和损害的真实生活实例。建议进行充分评估（包括诊断评估和初始诊断后讨论）需要2小时或更长时间。
AQAS已被开发为一种实用资源，以支持对成人ADHD进行可靠且有效的诊断评估。它旨在补充正规培训。第二个目标是通过向患者提供关于评估及评估报告预期内容的循证信息来增强患者的能力。
