Is it possible to determine the level of functional impairment that distinguishes the patients with ADHD from those without ADHD?
Functional impairment in attention deficit hyperactivity disorder (ADHD) can occur in many areas such as in family, social activities, and problems related to school and may also persist during adulthood. The Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P) is designed to measure the functional impairment related to ADHD symptoms. The aim of this study was to determine the level of functional impairment that distinguishes the patients with ADHD who were diagnosed through semi-structured interviews from those without ADHD.
This study consists of ADHD patients who were diagnosed through semi-structured interview aged 5–18 years (n = 250) and same age gender-matched healthy controls (n = 250). A receiver operating characteristic (ROC) curve was constructed by calculating the sensitivity and specificity of the scale cut-off values.
An area under the curve (AUC) of 0.974 (95% CI 0.956–0.986) was found in this study. For WFIRS-P subdomains, AUC curves, which range from 0.76 to 0.95, were also having strong power for differentiation between groups. The optimal cut-off value for WFIRS-P using Youden’s J Index is 0.32. There is no significant gender and age group differences in AUC for either the total or subdomain scores.
Our findings provide that Turkish version of WFIRS-P could be a reliable way of distinguishing the level of functional impairment in ADHD from controls.
KeywordsFunctional impairment Receiver operating characteristics Attention deficit hyperactivity disorder Youden’s J Index
- 8.Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). (2011). Canadian ADHD practice guide-lines (3rd edn.). Toronto: CADDRA.Google Scholar
- 14.Lewandowski, L. J., Lovett, B. J., Gordon, M. (2009). Measurement of symptom severity and impairment. In S. Goldstein, J. Naglieri (Eds). Assessing impairment: from theory to practice (pp. 5–14). New York: Springer.Google Scholar
- 15.Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., Loo, S. K., Carlson, C. L., McBurnett, K., & Lahey, B. B. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010.CrossRefGoogle Scholar
- 17.De Bruyckere, K., Bushe, C., Bartel, C., Berggren, L., Kan, C. C., & Dittmann, R. W. (2016). Relationships between functional outcomes and symptomatic improvement in atomoxetine-treated adult patients with attention-deficit/hyperactivity disorder: Post hoc analysis of an integrated database. CNS Drugs, 30(6), 541–558.CrossRefGoogle Scholar
- 20.Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Altaye, M. B.,, House, K., & Stark, L. J., Brink-man, W. M. (2010). Attention-deficit/hyperactivity disorder outcomes for children treated in community-based pediatric settings. Pediatrics, 164, 160–165.Google Scholar
- 22.O’Connor, B. C., Garner, A. A., Peugh, J. L., Simon, J., & Epstein, J. N. (2015). Improved but still impaired: Symptom-impairment correspondence among youth with attention-deficit hyperactivity disorder receiving community-based care. Journal of Developmental and Behavioral Pediatrics, 36, 106–114.CrossRefGoogle Scholar
- 24.European Medicines Agency. Guideline on the clinical investiga- tion of medicinal products for the treatment of attention deficit hyperactivity disorder (ADHD). Retrieved September 13, 2016, from http://www.ema.europa.eu/ docs/en_GB/document_library/Scientific_guideline/2009/09/ WC500003474.pdf.
- 25.Canu, W. H., Hartung, C. M., Stevens, A. E., & Lefler, E. K. (2016). Psychometric properties of the Weiss Functional Impairment Rating Scale: Evidence for utility in research, assessment, and treatment of ADHD in emerging adults. Journal of Attention Disorders. https://doi.org/10.1177/1087054716661421.CrossRefPubMedGoogle Scholar
- 27.Gajria, K., Kosinski, M., Sikirica, V., Huss, M., Livote, E., Reilly, K., Dittmann, R. W., & Erder, M. H. (2015). Psychometric validation of the Weiss Functional Impairment Rating Scale-Parent Report Form in children and adolescents with attention-deficit/hyperactivity disorder. Health Quality of Life Outcomes, 13, 184.CrossRefGoogle Scholar
- 28.Weiss, M. D., Brooks, B. L., Iverson, G. L., et al. (2007) Reliability and validity of the Weiss functional impairment rating scale. In World Psychiatry Association Conference, Shanghai.Google Scholar
- 29.Hodgkins, P., Lloyd, A., Erder, M. H., Setyawan, J., Weiss, M. D., Sasané, R., & Nafees, B. (2017). Estimating minimal important differences for several scales assessing function and quality of life in patients with attention-deficit/hyperactivity disorder. CNS Spectrums, 22(1), 31–40.CrossRefGoogle Scholar
- 32.Kaufman, J., Birmaher, B., Brent, D., et al. (1996). Kiddie-SADS-present and lifetime version (K-SADS-PL), version 1.0 of October 1996 edn. Pittsburgh: Department of Psychiatry, University of Pittsburgh School of Medicine.Google Scholar
- 33.Gökler, B., Ünal, F., & Pehlivantürk, B. (2004). Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-Turkish version (K-SADSPL-T). Turkish Journal of Child and Adolescent Mental Health, 11, 109–116.Google Scholar
- 34.Turgay, A. (1997). Turgay’s DSM-IV based ADHD and disruptive behaviour disorders screening scale. Toronto: Integrative Therapy Institute Publication.Google Scholar
- 35.Ercan, E. S., Amado, S., Somer, O., et al. (2001). Development of a test battery for the assessment of attention deficit hyperactivity disorder. Turkish Journal of Child and Adolescent Mental Health, 8, 132–144.Google Scholar