Neuropsychiatric Disease and Treatment (Oct 2020)
Application of Attention-Deficit/Hyperactivity Disorder Diagnostic Tools: Strengths and Weaknesses of the Korean ADHD Rating Scale and Continuous Performance Test
Abstract
Geun Hui Won, Tae Young Choi, Jun Won Kim Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of KoreaCorrespondence: Jun Won KimDepartment of Psychiatry, Catholic University of Daegu School of Medicine, 3056-6 Daemyeong-4 Dong, Nam-gu, Daegu 705-718, Republic of KoreaTel +82 53 650 4332Fax +82 53 623 1694Email [email protected]: We aimed to compare the Korean version of the ADHD Rating Scale (K-ARS) and Integrated Visual and Auditory Plus (IVA+Plus), a continuous performance test, by analyzing their abilities to distinguish different groups (attention-deficit/hyperactivity disorder [ADHD], ADHD-not otherwise specified [NOS], and normal control [NC]).Patients and Methods: Individuals of 7– 12 years of age who visited our child and adolescent psychiatric clinic were recruited. Seventy-four participants (58 males, 16 females) were classified into three groups according to results from the Korean Version of Diagnostic Interview Schedule for Children Version IV. The K-ARS and IVA+Plus were administered. An analysis of covariance (ANCOVA) was conducted. The tools’ accuracy in discriminating patients with ADHD or NOS from NCs was evaluated using a receiver operating characteristic (ROC) curve analysis.Results: ANCOVA revealed significant differences in the K-ARS results of the three groups (ADHD [n=29], NOS [n=33], NC [n=12]), whereas a difference in IVA+Plus results was observed only between the ADHD and NC groups. In the ROC curve analysis of the K-ARS, the areas under the curve (AUCs) for each group were 0.960 (ADHD vs NC), 0.885 (NOS vs NC), 0.920 (ADHD+NOS vs NC), and 0.779 (ADHD vs NOS+NC). In the ROC curve analysis for the IVA+Plus hyperactivity-impulsiveness scale, the AUCs for each group were 0.740 (ADHD vs NC), 0.643 (NOS vs NC), 0.688 (ADHD+NOS vs NC), and 0.626 (ADHD vs NOS+NC); those for the inattention scale were 0.731 (ADHD vs NC), 0.658 (NOS vs NC), 0.692 (ADHD+NOS vs NC), and 0.625 (ADHD+NOS vs NC).Conclusion: The K-ARS was useful to distinguish the ADHD and NOS groups from the NC group, while the IVA+Plus was useful to distinguish the ADHD group from the NC group. Clinicians should ensure they understand the properties of each tool and apply them appropriately in the diagnosis of ADHD.Keywords: diagnostic accuracy, patient assessment, hyperactivity-impulsiveness scale, inattention scale