Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a clinical sample.

Full Abstract

Previous validation studies of attention deficit/hyperactivity disorder (ADHD) assessment by rating scales or EEG have provided Class-IV evidence per standards of the American Academy of Neurology. To investigate clinical applications, we collected Class-I evidence, namely from a blinded, prospective, multi-center study of a representative clinical sample categorized with a clinical standard. Participating males (101) and females (58) aged 6 to 18 had presented to one of four psychiatric and pediatric clinics because of the suspected presence of attention and behavior problems. DSM-IV diagnosis was performed by clinicians assisted with a semi-structured clinical interview. EEG (theta/beta ratio) and ratings scales (Conners Rating Scales-Revised and ADHD Rating Scales-IV) were collected separately in a blinded protocol. ADHD prevalence in the clinical sample was 61%, whereas the remainder had other childhood/adolescent disorders or no diagnosis. Comorbidities were observed in 66% of ADHD patients and included mood, anxiety, disruptive, and learning disorders at rates similar to previous findings. EEG identified ADHD with 87% sensitivity and 94% specificity. Rating scales provided sensitivity of 38-79% and specificity of 13-61%. While parent or teacher identification of ADHD by rating scales was reduced in accuracy when applied to a diverse clinical sample, theta/beta ratio changes remained consistent with the clinician's ADHD diagnosis. Because theta/beta ratio changes do not identify comorbidities or alternative diagnoses, the results do not support the use of EEG as a stand-alone diagnostic and should be limited to the interpretation that EEG may complement a clinical evaluation for ADHD.

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Author information

Author/s: Snyder, Steven M (SM); Quintana, Humberto (H); Sexson, Sandra B (SB); Knott, Peter (P); Haque, A F M (AF); Reynolds, Donald A (DA);

Affiliation: Department of Psychology, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX 76107, USA. ssnyder@hsc.unt.edu

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Validation Studies

Journal: Psychiatry research (Psychiatry Res), published in Ireland. (Language: eng)

Reference: 2008-Jun; vol 159 (issue 3) : pp 346-58

Dates: Created 2008/05/20; Completed 2008/07/28;

PMID: 18423617, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Age Distribution
Anxiety Disorders - diagnosis; epidemiology
Attention Deficit Disorder with Hyperactivity - diagnosis; epidemiology; psychology
Attention Deficit and Disruptive Behavior Disorders - diagnosis; epidemiology
Beta Rhythm - statistics & numerical data
Child
Comorbidity
Diagnostic and Statistical Manual of Mental Disorders
Electroencephalography - statistics & numerical data

Female
Humans
Learning Disorders - diagnosis; epidemiology
Male
Mood Disorders - diagnosis; epidemiology
Prevalence
Prospective Studies
Psychiatric Status Rating Scales - statistics & numerical data
Sensitivity and Specificity
Theta Rhythm - statistics & numerical data

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