Abstract
Objective: The aim of this study was to examine the psychometric properties and diagnostic accuracy of the Swedish version of the Wender Utah Rating Scale (WURS) in psychiatric patients with similar symptoms but diagnosed with either attention deficit hyperactivity disorder (ADHD), bipolar disorder (BP), and/or borderline personality disorder (BPD).Methods: A total of 121 patients from an outpatient psychiatric clinic for young adults (18–25 years) were diagnosed using the Structured Clinical Interview for DSM Axis I and Axis II (SCID-I and SCID-II), and ADHD was diagnosed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). WURS were filled in by the participants and compared with a diagnosis of ADHD according to K-SADS.Results: Internal consistency of the WURS was 0.94. The principal component analysis resulted in a three-factor solution that accounted for 61.3% of the variance. The ADHD group had significantly higher mean scores compared to all other groups. The diagnostic accuracy of the WURS was examined using AUC and ROC analysis, and the optimal cut-off score was 39, with a sensitivity of 0.88 and specificity of 0.70, with AUC 0.87, 95% CI 0.80–0.94, PPV 0.59, and NPV 0.92.Conclusion: The psychometric properties of the Swedish WURS were good. For assessment of adult ADHD, in patients with symptoms of emotional instability, impulsivity, and attention problems but of different origins, a somewhat higher cut-off score than the originally suggested was preferable for identification of ADHD.
Highlights
Attention deficit hyperactivity disorder (ADHD) is mainly characterized by deficiency in sustaining attention, impulsivity, and/or hyperactivity [1]
Diagnosing attention deficit hyperactivity disorder (ADHD) in adulthood is challenging due to the need for retrospective recall and due to high rates of other psychiatric disorders with similar symptoms [5,6,7]. Such disorders are bipolar disorder (BP) and borderline personality disorder (BPD), which both present with symptoms that overlap with ADHD symptoms, for example emotional instability and impulsivity
We compared the mean Wender Utah Rating Scale (WURS)-25 scores for the individuals that met the criteria for ADHD (n 1⁄4 40) with the mean scores of the individuals with BPD (n 1⁄4 17), BP (n 1⁄4 30), BPD and BP (n 1⁄4 14), and the individuals with subclinical diagnoses (n 1⁄4 20)
Summary
Attention deficit hyperactivity disorder (ADHD) is mainly characterized by deficiency in sustaining attention, impulsivity, and/or hyperactivity [1]. Diagnosing ADHD in adulthood is challenging due to the need for retrospective recall and due to high rates of other psychiatric disorders with similar symptoms [5,6,7]. Such disorders are bipolar disorder (BP) and borderline personality disorder (BPD), which both present with symptoms that overlap with ADHD symptoms, for example emotional instability and impulsivity. Children diagnosed with ADHD have been reported to have an increased risk of developing BPD in late adolescence [8]. Co-occurrence between ADHD and BP or BPD is reported to be around 20% [9]
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