Abstract

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which typically presents in childhood. This diagnosis may often be overlooked in adulthood, particularly in psychiatric populations. The Adult ADHD Self-Report Scale (ASRS) is an internationally used and reliable screener; however, studies investigating its use in African populations are limited.AimTo investigate the application of the ASRS in a South African setting.SettingA patient population in Port Elizabeth, South Africa, was identified as representing a developing or low- and middle-income country population.MethodsA convenience sample of acutely presenting psychiatric participants admitted for stabilisation was used. Fieldworkers administered the ASRS; collected information relating to demographics, differential diagnoses, substance use disorder (SUD) presence and substance consumption; and prescribed medication relating to current or historical treatment of ADHD.ResultsThe study sample included 30 participants, with black people representing the majority of participants. Adult ADHD Self-Report Scale completion revealed the rate of ADHD within the study population to be 43.3%, a contrast to the initially presumed prevalence of 6.7% which was based on reported methylphenidate therapy. A difference in SUD prevalence was identified between subjects screening positively and negatively for ADHD with a greater tendency towards SUDs seen for ASRS-positive individuals. Significant differences were identified in relation to cannabis- and polysubstance use for ASRS-positive individuals.ConclusionDespite limitations related to the sample used and challenges in ASRS administration, investigation findings support recommendations for ADHD screening inclusion in acute inpatient settings in South Africa and ASRS translation into indigenous African languages.

Highlights

  • Attention-deficit/hyperactivity disorder (ADHD) is defined as a neurodevelopmental disorder which is characterised by inattention, hyperactivity, impulsiveness and poor organisation.[1,2,3] ADHD is fundamentally a cognitive disorder wherein there is a developmental impairment of executive functions (EFs) – complex cognitive processes that form the controlling system of the brain.[4,5,6,7] According to Barkley,[8] emotion is an important element to include when conceptualising ADHD

  • Conceptualised as a childhood condition which is ‘outgrown’ during adolescence, ADHD has been described in adult populations for several decades, but its persistence in adulthood was only officially recognised in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).[1,9,10]

  • Determination of Cronbach’s α for both the ADHD Self-Report Scale (ASRS)-A and ASRS-18 within the study population revealed the internal consistency to be adequate for the ASRS Part A (ASRS-A) and excellent for the full scale ASRS

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Summary

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is defined as a neurodevelopmental disorder which is characterised by inattention, hyperactivity, impulsiveness and poor organisation.[1,2,3] ADHD is fundamentally a cognitive disorder wherein there is a developmental impairment of executive functions (EFs) – complex cognitive processes that form the controlling system of the brain.[4,5,6,7] According to Barkley,[8] emotion is an important element to include when conceptualising ADHD. Emotions are not necessarily more intensely felt in persons with ADHD but are more quickly displayed and seem more marked. They are less moderated by executive ­self-regulation. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which typically presents in childhood. This diagnosis may often be overlooked in adulthood, in psychiatric populations. The Adult ADHD Self-Report Scale (ASRS) is an internationally used and reliable screener; studies investigating its use in African populations are limited

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