European Child & Adolescent Psychiatry

, Volume 15, Supplement 1, pp i46–i55 | Cite as

Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study

  • Manfred DöpfnerEmail author
  • Hans-Christoph Steinhausen
  • David Coghill
  • Søren Dalsgaard
  • Lynne Poole
  • Stephen J. Ralston**
  • Aribert Rothenberger
  • ADORE Study Group*



To provide psychometric information on the Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV (ADHD-RS-IV) in a large population of children with ADHD.


Patients aged 6–18 years (n=1,478 in baseline analysis) were rated by 244 physicians on the ADHD-RS-IV based on a semistructured interview with the patient's parent. Physicians additionally rated functional impairment (CGAS) and health status (CGI-S), and parents rated their child's behavioural and emotional problems (SDQ) and quality of life (CHIPCE).


Inattention and hyperactivity-impulsivity as dimensions of ADHD were replicated. 3-factor solutions reflecting the ICD-10 definition, with hyperactivity, impulsivity and inattention as separate dimensions were extracted in some national sub-samples and in separate analyses for boys and younger children.Good internal consistencies, strong country effects and small effects of age were found. Based on ADHD-RS-IV, 88.5% of patients met the criteria for any ADHD diagnosis. Correlations between ADHD-RS-IV and measures of functional impairment were low but statistically significant. The correlations with SDQ and CHIPCE scales confirm the convergent and divergent validity of ADHDRS-IV.


Impressive evidence for the cross-cultural factorial validity, internal consistency as well as convergent and divergent validity of ADHD-RS-IV was found. ADHD can be assessed reliably and validly in routine care across Europe. The ICD-10 3-factor model seems to be less robust than the DSM-IV 2-factor model, but may be a good description for special populations (boys, younger children).

Key words

ADHD ADORE assessment children cross-cultural validation 



Attention-Deficit/Hyperactivity Disorder


Attention-deficit/hyperactivity Disorder Observational Research in Europe


ADHD Rating Scale-IV


Child Health and Illness Profile – Child Edition


Children's Global Assessment Scale


Clinical Global Impression-Severity scale


Strengths and Difficulties Questionnaire


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Copyright information

© Steinkopff Verlag 2006

Authors and Affiliations

  • Manfred Döpfner
    • 1
    Email author
  • Hans-Christoph Steinhausen
    • 2
  • David Coghill
    • 3
  • Søren Dalsgaard
    • 4
  • Lynne Poole
    • 5
  • Stephen J. Ralston**
  • Aribert Rothenberger
    • 6
  • ADORE Study Group*
  1. 1.Dept. of Child and Adolescent PsychiatryUniversity of CologneKölnGermany
  2. 2.Dept. of Child and Adolescent PsychiatryUniversity of ZürichZürichSwitzerland
  3. 3.Section of Psychiatry Division of Pathology and NeuroscienceUniversity of DundeeDundee, ScotlandUK
  4. 4.Dept. of Child and Adolescent PsychiatryUniversity of AarhusAarhusDenmark
  5. 5.Eli Lilly and CompanyBasingstoke, HampshireUK
  6. 6.Dept. of Child and Adolescent PsychiatryUniversity of GöttingenGöttingenGermany

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