Wender Utah Rating Scale Research Articles

Is There Any Relationship between ADHD Symptoms and Choosing Sports Education at the University?

The goal of our study was to compare the incidence of Attention Deficit Hyperactivity Disorder (ADHD) observed in students at the School of Physical Education and Sports (SPES), which is a school that provides higher education in athletics, with that observed in students studying in other departments of the university. Our hypothesis was that people with ADHD most commonly turn to sports. The study enrolled 318 (75.7% of 420) students who were studying in the SPES of Gaziantep University; 277 students from the medical, nursing, administration, and engineering faculties were enrolled to serve as a control group. All students enrolled in the study were informed about the study before the lesson, and the students who agreed to participate provided written consent. Scales used in this study were: a sociodemographic information form which was prepared by the investigators, the Wender-Utah Rating Scale (WURS), and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (ADD/ADHD). WURS scores were significantly higher (25.07 +/- 15.15 versus 21.37 +/- 14.28; p = 0.002) in the SPES group than the control group. In addition, the percentage of subjects with a WURS score above the cut-off of 36 was higher in the SPES group than the control group (22.4% versus 15.2%; p: 0.028). The two groups were not significantly different in terms of the subscales of the ADD/ADHD scale. A correlation was found between the educational achievement of the students in the SPES group and the ADD/ADHD-inattention subscale (r = .111, p = 0.015) and WURS scale (r = .113, p = 0.011). More systematic studies with larger samples in this domain will be useful in obtaining a clearer picture regarding professional attraction of people with ADHD to sports.

Among a sample of Iranian students, adult attention deficit hyperactivity disorder is related to childhood ADHD, but not to age, gender, socioeconomic status, or birth order—an exploratory study

Objective. The aim of the present study was to explore the prevalence of adult attention deficit hyperactivity disorder (ADHD) in young adult Iranian students and to examine gender, birth order, socioeconomic status (SES), and history of ADHD as potential predictors of adult ADHD. Methods. A total of 387 young adult students (mean age: 19.6 years; 66.3% females) completed the Adult ADHD Self-Report Scale-V1.1 symptom checklist to assess current symptoms of ADHD and the Wender Utah Rating Scale to assess symptoms of ADHD in childhood and adolescence. Experts’ ratings were based on Wender–Reimherr Interview. Results. Self-rated and expert-rated prevalence rates were 16.5% and 13.4%, respectively. Past symptoms of ADHD were correlated with current symptoms. Childhood ADHD, current hyperactivity, and disorganization predicted current ADHD. Conclusions. Among a sample of Iranian students, the prevalence rates of ADHD were higher than estimated rates worldwide. Data also show child ADHD to be associated with adult ADHD; gender, age, birth order, and SES did not seem to influence current symptomatology.

Predictors of methamphetamine psychosis: History of ADHD-relevant childhood behaviors and drug exposure

The goal of this study was to extend our previous research that reported a significant association between Attention Deficit Hyperactivity Disorder (ADHD)-relevant childhood behaviors and the frequency of methamphetamine (MA)-induced psychotic symptoms in an expanded sample. 190 participants who met DSM-IV criteria for MA dependence were administered the Methamphetamine Experience Questionnaire that assessed MA-induced psychosis. Data related to MA exposure, comorbid drug use, education, familial psychiatric history and assessments of ADHD-relevant childhood behaviors as measured by the Wender Utah Rating Scale (WURS) were collected. Although WURS scores did not differ between 145 MAP+ and 45 MAP- subjects, MAP+ subjects with higher WURS scores were significantly more likely to report more frequent psychosis. Although mean daily MA dosage did not differ between the MAP+ and MAP- subjects, MAP+ subjects who consumed larger doses of MA were significantly more likely to experience frequent psychosis. These data suggest that ADHD-relevant childhood behaviors may interact with MA exposure to reflect a neurobiological vulnerability related to the emergence of frequent MA-induced psychotic symptoms. These results may elucidate factors that contribute to the psychiatric sequelae of MA abuse.

On the relationship between retrospective childhood ADHD symptoms and adult BPD features: The mediating role of action-oriented personality traits

A number of studies have reported data suggestive of a significant association between ADHD and BPD, nevertheless, the nature of this relation has not been fully understood yet. In our study, we tried to evaluate if the relationship between retrospectively assessed ADHD symptoms and adult BPD features could mediated by selected temperament/personality traits. Four hundred forty-seven in- and outpatients consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered the Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II), Wender Utah Rating Scale (WURS), Temperament and Character Inventory-Revised (TCI-R), Barratt Impulsiveness Scale-11 (BIS-11), and Aggression Questionnaire (AQ). Our mediation analyses showed that the combination of impulsivity, aggression, novelty seeking, and juvenile conduct problems completely mediate the relationship between retrospectively assessed ADHD symptoms and current BPD features.

A Retrospective Survey of Childhood ADHD Symptomatology Among Adult Narcoleptics

Objective: This study examined the retrospective history of childhood ADHD symptomatology in an adult narcoleptic population (Narcolepsy Group [NG]: n = 161) compared with a control group (CG: n = 117). Method: Both groups completed the Wender Utah Rating Scale (WURS), a retrospective self-report questionnaire indicating the presence of childhood ADHD symptomatology in adults. Results: Childhood ADHD symptoms were significantly greater in NG than CG (p < .001). Joint prevalence calculations of childhood ADHD symptomatology in NG were more than 8 to 15 times greater than expected. Among NG, those individuals with a greater score on the WURS, indicative of childhood ADHD symptomatology, also had shorter sleep onsets on the Multiple Sleep Latency Test, a common objective measure of sleepiness, t(97) = −7.11, p < .05. Conclusion: It appears that self-reported childhood ADHD symptomatology history among adult narcoleptics is common. Future research is warranted with adult narcoleptics to elucidate the true nature of this.

Comparison of Web-Based and Paper-Based Administration of ADHD Questionnaires for Adults

BackgroundSatisfactory psychometric properties in offline questionnaires do not guarantee the same outcome in Web-based versions. Any construct that is measured online should be compared to a paper-based assessment so that the appropriateness of online questionnaire data can be tested. Little research has been done in this area regarding Attention-Deficit/Hyperactivity Disorder (ADHD) in adults.ObjectiveThe objective was to simultaneously collect paper-based and Web-based ADHD questionnaire data in adults not diagnosed with ADHD in order to compare the two data sources regarding their equivalence in raw scores, in measures of reliability, and in factorial structures.MethodsData from the German versions of the Connors Adult ADHD Rating Scales (CAARS-S), the Wender Utah Rating Scale (WURS-k), and the ADHD Self Rating Scale (ADHS-SB) were collected via online and paper questionnaires in a cross-sectional study with convenience sampling. We performed confirmatory factor analyses to examine the postulated factor structures in both groups separately and multiple group confirmatory factor analyses to test whether the postulated factor structures of the questionnaires were equivalent across groups. With Cronbach alpha, we investigated the internal consistency of the postulated factors in the different questionnaires. Mann-Whitney U tests with the effect size “Probability of Superiority (PS)” were used to compare absolute values in the questionnaires between the two groups.ResultsIn the paper-based sample, there were 311 subjects (73.3% female); in the online sample, we reached 255 subjects (69% female). The paper-based sample had a mean age of 39.2 years (SD 18.6); the Web-based sample had a mean age of 30.4 years (SD 10.5) and had a higher educational background. The original four factor structure of the CAARS-S could be replicated in both samples, but factor loadings were different. The Web-based sample had significantly higher total scores on three scales. The five-factor structure of the German short form of the WURS-k could be replicated only in the Web-based sample. The Web-based sample had substantially higher total scores, and nearly 40% of the Web-based sample scored above the clinically relevant cut-off value. The three-factor structure of the ADHS-SB could be replicated in both samples, but factor loadings were different. Women in the Web-based sample had substantially higher total scores, and 30% of the Web-based sample scored above the clinically relevant cut-off value. Internal consistencies in all questionnaires were acceptable to high in both groups.ConclusionsData from the Web-based administration of ADHD questionnaires for adults should not be used for the extraction of population norms. Separate norms should be established for ADHD online questionnaires. General psychometric properties of ADHD questionnaires (factor structure, internal consistency) were largely unaffected by sampling bias. Extended validity studies of existing ADHD questionnaires should be performed by including subjects with a diagnosis of ADHD and by randomizing them to Web- or paper-based administration.

The comorbidity of adult attention-deficit/hyperactivity disorder in bipolar disorder patients

ObjectiveHigh comorbidity ratio of bipolar mood disorder (BMD) with Axis I and Axis II diagnoses is reported in the literature. The possible relationship between BMD and attention-deficit/hyperactivity disorder (ADHD) in all age groups has been attracting more attention of researchers due to highly overlapping symptoms such as excessive talking, attention deficit, and increased motor activity. In this study, we aimed to investigate the prevalence of ADHD comorbidity in BMD patients and the clinical features of these patients. MethodsOf 142 patients, who presented to the Bipolar Disorder Unit of Zonguldak Karaelmas University Research and Application Hospital between the dates of August 1, 2008 and June 31, 2009 and diagnosed with BMD according to DSM-IV criteria consecutively, 118 patients signed informed consent and 90 of them completed the study. They all were in euthymic phase during the study evaluations. A sociodemographical data form, Wender-Utah Rating Scale (WURS), ADD/ADHD Diagnostic and Evaluation Inventory for Adults, and Structural Clinical Interview for DSM-IV Axis I Disorders, Clinical Version (SCID-I) were applied to all participating patients. ResultsA total of 23.3% of all patients met the criteria for A-ADHD diagnosis along BMD. No difference was detected regarding sociodemographical features between the BMD+A-ADHD and the BMD without A-ADHD groups. The BMD+A-ADHD group had at least one extra educational year repetition than the other group and the difference was statistically significant. The BMD starting age in the BMD+A-ADHD group was significantly earlier (p=0.044) and the number of manic episodes was more frequent in the BMD+A-ADHD group (p=0.026) than the BMD without ADHD group. Panic disorder in the BMD+A-ADHD group (p=0.019) and obsessive-compulsive disorder in the BMD+C-ADHD group (p=0.001) were most frequent comorbidities. ConclusionsA-ADHD is a frequent comorbidity in BMD. It is associated with early starting age of BMD, higher number of manic episodes during the course of BMD, and more comorbid Axis I diagnoses.

2822 – Impulsivity and attention deficit-hyperactivity symptoms among female patients with obesity

The relationship between obesity and Attention Deficit-Hyperactivity Disorder(ADHD) has been studied in recent years. It was indicated that the proportion of ADHD in children with obesity was high and body mass index (BMI) of children with ADHD was also higher than healthy controls [1]. Impulsivity as a trait was found to be associated with obesity and predictor of future weight gain among children with obesity (2,3). From here, we aim to evaluate the impulsivity and ADHD symptoms among adults with obesity. 32 female patients with obesity (BMI>30) who admitted to the diet clinic of Çanakkale Onsekiz Mart University Medical Faculty were recruited for the study. ADHD symptoms were evaluated with Wender Utah Rating Scale(WURS) while impulsivity was measured with Barratt Impulsiveness Scale(BIS). Mean age, BMI, WURS and BIS scores of the patiens were 35.3 ± 10.8 years, 39.2 ± 6.2 kg., 35.8 ± 19.2 and 61.3 ± 10.4, respectively. 42.3% of the patiens had child and adolescent ADHD symptoms and one third still had ADHD symptoms in adulthood (12.5% inattentive, 9.4% hyperactive-impulsive, 6.2% combined). BIS total(p+0.003), BIS attention(p < 0.01) and self control(p = 0.004) sub-item scores were positively correlated with WURS total scores. Our findings were consistent the literature that patients with obesity were more impulsive than healthy controls(4). ADHD and impulsivity might have implications for weight regulation. Our findings may provide a frame work for future studies with bigger sample sizes aiming to detect the relationship between impulsivity and ADHD symptoms in patients with obesity.

Executive Cognitive Dysfunction and ADHD in Cocaine Dependence: Searching for a Common Cognitive Endophenotype for Addictive Disorders

Background: Cocaine-dependent individuals (CDI) present executive cognitive function (ECF) deficits, but the impact of psychiatric comorbidities such as Attention-Deficit Hyperactivity Disorder (ADHD) on neuropsychological functioning is still poorly understood. The aim of this study was to investigate if CDI with ADHD (CDI + ADHD) would have a distinct pattern of executive functioning when compared with CDI without ADHD (CDI).Methods: We evaluated 101 adults, including 69 cocaine-dependent subjects (divided in CDI and CDI + ADHD) and 32 controls. ECF domains were assessed with Digits Forward (DF), Digits Backward (DB), Stroop Color Word Test (SCWT), the Wisconsin Card Sorting Test (WCST), and the Frontal Assessment Battery (FAB). DSM-IV criteria for ADHD were used for diagnosis and previous ADHD symptoms (in the childhood) were retrospectively assessed by the Wender-Utah Rating Scale (WURS).Results: There were no significant differences between CDI + ADHD, CDI, and controls in estimated intellectual quotient (IQ), socioeconomic background, education (in years), and pre-morbid IQ (p > 0.05). SCWT and WCST scores did not differ across groups (p > 0.05). Nevertheless, CDI and CDI + ADHD performed more poorly than controls in total score of the FAB (p < 0.05). Also, CDI + ADHD did worse than CDI on DF (F = 4.756, p = 0.011), DB (F = 8.037, p = 0.001), Conceptualization/FAB (F = 4.635, p = 0.012), and Mental flexibility/FAB (F = 3.678, p = 0.029). We did not find correlations between cocaine-use variables and neuropsychological functioning, but previous ADHD symptoms assessed by WURS were negatively associated with DF (p = 0.016) and with the total score of the FAB (p = 0.017).Conclusion: CDI + ADHD presented more pronounced executive alterations than CDI and CDI exhibited poorer cognitive functioning than controls. Pre-existing ADHD symptoms may have a significant negative impact on executive dysfunction in CDI. It remains to be investigated by future studies if symptoms such as impulsivity or a pre-existing ECF dysfunction could represent underlying cognitive endophenotypes that would substantially increase the risk for acquiring addictive disorders.

2846 – A multicentre study on adult attention-deficit/hyperactivity disorder in subjects with affective disorders: role of personality traits and clinical implications

A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits, and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available. The sample consisted of 296 subjects, divided into three homogeneous groups according to demographic characteristics: 106 subjects diagnosed with major depressive disorder, 92 with bipolar disorders and 98 healthy controls. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale (WURS), the Adult ADHD Self-rating Scale (ASRS) and the Brown Attention Deficit Disorder Scale (ADD). The Hospital Anxiety and Depression Scale (HAD) and the Revised NEO Personality Inventory (NEO-PI-R) were also administered to the clinical groups, in order to investigate depressive/anxious symptoms and personality dimensions. The prevalence of adult ADHD in subjects with bipolar disorders or major depressive disorder was 22.0% and 8.5% respectively (p < .001), compared to 3.1% in healthy controls. Significant associations between personality traits, depressive/anxious symptoms and ADHD features were found. The present study emphasises the close relationship between affective disorders, especially bipolar disorders, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible co-existing ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.

Temperamental Characteristics in Adults with Attention-Deficit Hyperactivity Disorder: A Comparison with Bipolar Disorder and Healthy Control Groups

ObjectiveTo date, the affective temperamental characteristics of adults with attention-deficit hyperactivity disorder (ADHD) have not been studied. The aim of this study is to explore those temperamental characteristics for adults diagnosed with ADHD as measured by the TEMPS-A and then to compare those results with results for individuals diagnosed with bipolar disorder (BD) and with healthy controls.MethodsForty adults with ADHD, 40 patients with BD, and 40 healthy controls were enrolled in this study. The groups were matched by age and gender. All patients were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Young Mania Rating Scale and the Wender Utah Rating Scale. Subjects' temperamental characteristics were examined using the Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A).ResultsTen subjects (25%) in the ADHD group and 15 subjects (30%) in the bipolar group had at least one dominant temperament. There was no identifiable dominant temperament in the control group. Compared to the control group, the ADHD group scored higher than other groups on all domains of the TEMPS-A: depressive cyclothymic, irritable and anxious. However, the hyperthymic domain was not higher for this group. Adults with ADHD scored higher on the irritable temperament scale as compared to the BD group. The ADHD and BD groups had similar mean scores for each of the other four temperaments.ConclusionThe adults diagnosed with ADHD in this study had different temperamental characteristics from the control group, and these temperamental characteristics were similar to those of the bipolar patients. Recognizing the role of temperamental characteristics in adults with ADHD may increase our understanding of ADHD.

2628 – Prevalence and characteristics of adult attention-deficit hyperactivity disorder among substance use inpatients

Comorbidity is common among adults with ADHD, including substance abuse. To our knowledge relation between ADHD and SUD has not been studied in Arab countries. Assessment of scope of comorbidity between ADHD and SUD in Egyptian patients. Estimating prevalence rate of adult ADHD among substance use inpatients and to compare substance use inpatients with and without adult ADHD regarding onset, and severity of SUD. This cross-sectional comparative study was conducted in addiction treatment center at El Maamoura psychiatric hospital. One Hundred and two adult males were assessed using Arabic version of Wender Utah Rating Scale (WURS) for retrospective assessment of symptoms of childhood ADHD. Arabic version of Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. DSM IV TR criteria were used for final diagnosis. 36 patients were diagnosed as having adult ADHD (35.3%) according to DSM-IV TR criteria. Presence of adult ADHD was associated with an earlier mean age of onset of SUD (15.58 vs. 13.22 years) and larger number of hospital admissions, (6.83 vs. 3.39 times). ADHD subjects achieved a shorter mean period of abstinence (124.53 vs. 209.82 days). Data were fed to the computer using the Predictive Analytics Software (PASW Statistics 18). Significance of the obtained results was judged at the 5% level. The results of this study confirm the high rates of adult ADHD among substance use patients mentioned in other studies. Presence of adult ADHD was associated with a more complicated course of SUD.

2709 – Impact of attention-deficit hyperactivity disorder “ADHD” across lifespan on substance use disorders “SUD”

Introduction Attention-deficit hyperactivity disorder (ADHD) affects not only children but persists for up to 4.4% in the general population. Comorbidity is common among adults with ADHD, including substance abuse. Objectives Assessment of impact of both childhood and adult ADHD on SUD. Aim The aim of this study was to estimate prevalence rate of past history of childhood ADHD and current adult ADHD among substance use inpatients and to compare between the two groups regarding onset and severity of substance use disorder. Methods This cross-sectional comparative study was conducted in addiction treatment center at El Maamoura psychiatric hospital. One hundred and two adult males were assessed using Arabic version of Wender Utah Rating Scale (WURS) for retrospective assessment of symptoms of childhood ADHD. Arabic version of Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. DSM IV TR criteria were used for final diagnosis. Results Sixty Four patients of the total studied sample had past history of childhood ADHD. Of which, only 36 patients fulfilled the DSM - IV TR criteria for adult ADHD. Presence of adult ADHD was associated with an earlier mean age of onset of SUD (13.22 vs. 14.86 years), larger number of hospital admissions, (4.21 vs. 6.83 times) and a shorter mean period of abstinence (124.53 vs. 271.50 days). Conclusions In comparison to childhood ADHD, presence of adult ADHD was associated with a more complicated course of substance use disorders and poorer outcome.

Association of dopamine transporter gene variants with childhood ADHD features in bipolar disorder

Bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) exhibit remarkably high rates of comorbidity, as well as patterns of familial co-segregation. Epidemiological data suggests that these disorders either share a common genetic architecture or that ADHD features in BD may represent an etiologically distinct subtype. We previously used the Wender Utah Rating Scale (WURS) to assess ADHD features in BD families and identified three heritable factors relating to impulsivity, mood instability, and inattention. Linkage analysis revealed a LOD score of 1.33 for the inattention factor on 5p15.3 near the dopamine transporter gene (DAT1), which has been associated with both BD and ADHD. Pharmacological evidence also suggests a role for DAT in both disorders. We have now evaluated the association of ten DAT1 variants for the WURS total score and factors in an overlapping sample of 87 BD families. Significant associations for three SNPs were observed across the WURS measures, notably for a SNP in intron 8 with the WURS total score (P = 0.007) and for variants in introns 9 and 13 with mood instability (P = 0.009 and 0.004, respectively). Analysis of an independent sample of 52 BD cases and 46 healthy controls further supported association of the intron 8 variant with mood instability (P = 0.005), and a combined analysis confirmed the associations of this SNP with WURS total score. Impulsivity and mood instability (P = 0.002, 0.007, and 8 × 10(-4), respectively). These data suggest that variants within DAT1 may predispose to a subtype of BD characterized by early prodromal features that include attentional deficits.

ADHD symptoms across the lifespan in a population-based Swedish sample aged 65 to 80

The purpose of the study was to examine the attention deficit hyperactivity disorder (ADHD) symptomatology across the lifespan by comparing older individuals' self-reports about current ADHD symptoms and symptoms in childhood. The 25-item Wender Utah Rating Scale (WURS) was initially administered in a population-based sample of 1,599 persons aged 65-80 years. We also asked about current health, memory, and problems in childhood. Based on their WURS scores (below and above 36), we randomly drew two subsamples, each with 30 individuals. They were followed up by the Wender Riktad ADHD Symtom Skala (WRASS)-scale, a Swedish version of the Targeted Attention Deficit Disorder Rating Scale (TADDS). Our main finding was that higher WURS scores were significantly related to higher scores on the WRASS scale, indicating persistence of self-reported ADHD symptoms over the whole lifespan. Among those with a WURS score of 36 or more, 16 (53.3%) individuals scored 70 or more; the clinical cut-off used in Sweden. None of the individuals with a WURS score below 36 scored higher than 70 on the WRASS scale. Our findings support the idea of a significant persistence of ADHD symptoms from childhood to old age. The results encourage studies of ADHD using a lifespan perspective, particularly in examining ADHD symptoms in old age.

Childhood ADHD Symptoms Are Associated With Lifetime and Current Illicit Substance-Use Disorders and In-Site Health Risk Behaviors in a Representative Sample of Latino Prison Inmates

Objective: This study aimed to explore retrospective childhood ADHD symptomatology, psychiatric comorbidity, rates of substance-use disorders (SUD), as well as their association with high-risk health behaviors in prison and adverse health outcomes. Method: A randomly selected representative sample of inmates in the Puerto Rico correctional system (N = 1,179) was assessed with the Spanish-language Wender Utah Rating Scale (WURS); the Composite International Diagnostic Interview (CIDI) modules for lifetime/current major depression disorder (MDD), generalized anxiety disorder (GAD), and SUD; the Davidson Trauma Scale (DTS; posttraumatic stress disorder [PTSD]); and self-reports of in-site high-risk behaviors. Results: Wald χ2 tests revealed significant associations of ADHD with MDD and PTSD, as well as increased risk for overdosing and intravenous drug use in prison. A logistic regression model adjusted for mood and anxiety comorbidity predicted lifetime SUD diagnosis (odds ratio = 2.38; 95% confidence interval = [1.15, 4.94]). Conclusion: Our results provide further evidence on the association of drug dependence and ADHD symptoms, and their overrepresentation among prison inmates.

The Utility of Attention-Deficit/Hyperactivity Disorder Screening Instruments in Individuals Seeking Treatment for Substance Use Disorders

Several screening tools for attention-deficit/hyperactivity disorder (ADHD) have been validated in non-substance-abusing populations, but limited data are available regarding their utility in adults with current substance use disorders. The aim of this study was to determine the sensitivity, specificity, and positive and negative predictive values of 3 commonly used ADHD screening instruments in cocaine-dependent individuals. Adults seeking treatment for cocaine dependence (N = 102) were administered 3 self-report instruments between May 2009 and April 2011: the Conners Adult ADHD Rating Scale (CAARS), the Wender Utah Rating Scale (WURS), and the Adult ADHD Self-Report Scale-Version 1.1 (ASRS-V1.1). They then met with master's-level clinicians who administered the Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID). With the CAADID serving as the gold standard, the validity of the screening instruments was determined, both singly and in combination. Twenty-five (25%) of the 102 patients met DSM-IV criteria for ADHD or ADHD not otherwise specified (NOS) based on the CAADID. Kappa scores determining agreement between the screening tools and the CAADID (with ADHD NOS labeled as ADHD or labeled as not ADHD) ranged from 0.37 to 0.69. Sensitivity scores for the broadest range of ADHD cases were 80.0%, 87.5%, and 60.9% for the CAARS, WURS, and ASRS-V1.1, respectively. Positive predictive value was highest for the CAARS, at 74.1%, and negative predictive value was highest for the WURS, at 95.1%. The highest sensitivity (96.0%) was found with coadministration of the WURS and CAARS. While all of the screening instruments were found to have adequate sensitivity and specificity, the CAARS outperformed the other instruments in regard to agreement with the CAADID and positive predictive values. However, the WURS, with the highest sensitivity in regard to the broadest range of ADHD cases, may be the single best instrument for preliminary screening purposes. Further, because the ASRS-V1.1 is the simplest and shortest instrument to administer, it may have advantages when a large number of patients need to be screened.

P.7.b.005 Decreased serum levels of brain derived neurotrophic factor in adults with ADHD

Emotional dysregulation in subjects with attention deficit and hyperactivity disorder (ADHD) is a topic of growing interest among clinicians and researchers. The present study aims at investigating components of emotional dysregulation in adults ADHD compared to subjects suffering from bipolar disorder (BD).A total of 150 adults ADHD, 335 adults BD subjects and 48 controls were assessed using the Affective Lability Scale (ALS) and the Affect Intensity Measure (AIM), measuring respectively emotion lability and emotion responsiveness.ADHD and BD subjects scored significantly higher on the ALS compared to controls (p=0.0001). BD subjects scored above ADHD ones (3.07 (SD=0.66) vs. 2.30 (SD=0.68); p<0.0001). The average total scores achieved on the AIM were significantly different for the three groups (p=0.0001) with significantly higher scores for ADHD subjects compared to BD ones (3.74 (SD=0.59) vs. 3.56 (SD=0.69); p<0.0001).Suspected cases of ADHD in the BD and control groups were derived from the Wender Utah Rating Scale (WURS). This study is a retrospective one.Our study thus highlights the importance of emotional dysregulation in adults suffering from ADHD, showing that they display higher emotional intensity than bipolar disorder subjects and controls. Although the current diagnostic criteria of ADHD do not contain an emotional dimension, a better recognition of the significance of emotional responsiveness in ADHD patients can improve the care afforded to these patients, beyond the inattentive and hyperactive/impulsive components.

Attention-deficit hyperactivity disorder in patients with premature ejaculation: a pilot study

The etiology of both adult-type ADHD and PE is not completely understood, but the studies revealing common etiologic factors for both conditions suggest a high likelihood of coexistence. We aimed to find out the prevalence of ADHD among adult males with lifetime PE. The patients with lifetime PE were included in the study. Both patients and controls were evaluated with the 10-item premature ejaculation index of Althof and Rosen for premature ejaculation, Wender Utah rating scale (WURS) and Conner's adult ADHD rating scales (CAARS) for determining the presence of attention-deficit hyperactivity disorder syndrome. A total of 38 patients and 27 controls were included in the study. Patient and control groups were similar in terms of age and (p < 0.878), but different IELT (p < 0.001). ADHD was detected in 16 (42.1 %) of patients with PE, while ADHD symptoms were detected in only 1 (3.7 %) of control patients. Distribution of patients in the study group according to ADHD types was as follows: Type 1, Type 2, Type 3 in 2 (5.3 %), 4 (10.5 %), and 10 (26.3 %) patients, respectively. ADHD is significantly more frequent among patients with PE than controls. The close relationships between these two diseases must be examined by prospective studies.

Attention Deficit Hyperactivity Disorder and Obsessive-Compulsive Disorder among Former Heroin Addicts Currently in Methadone Maintenance Treatment

Background: The aim of this study was to evaluate the prevalence of childhood and adulthood attention deficit hyperactivity disorder (ADHD) and clinical obsessive-compulsive disorder (OCD) among adult patients in methadone maintenance treatment (MMT) and to characterize possible risk factors. Sampling andMethods: A random sample of 154 current MMT patients was studied for childhood ADHD (Wender Utah Rating Scale), current clinical OCD (Yale-Brown Obsessive Compulsive Scale), lifetime trauma history and modified Addiction Severity Index for demographics, as well as any lifetime DSM-IV-TR psychiatric diagnosis. Results: Fifty-one patients (33.1%) had childhood ADHD, and more of this group currently had clinical OCD compared to patients who did not have childhood ADHD (55.3 vs. 30.1%). The two groups did not differ with regard to gender and age of admission to MMT. Logistic regression found that the childhood ADHD group had a higher risk of having OCD [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.6–8.8], more severe nicotine smoking (OR 1.4, 95% CI 1.1–1.7) and fewer years of education (OR 0.8, 95% CI 0.6–1) and were more likely to have a DSM-IV-TR axis II disorder (OR 4.3, 95% CI 1.4–13.4) and a history of falls (OR 4.3, 95% CI 1.4–12.9). Conclusions: Although ADHD is more prevalent among males in the general population, the rates in our MMT population were similar in each gender. One third of our sample had suffered from ADHD during childhood, which may have led them to self-medicate with drugs and thus to addiction. Childhood ADHD was associated with current OCD, and both conditions were highly prevalent among our MMT patients. The reason for a history of repeated falls warrants further study.