{"title":"衡量成人多动症诊所的临床成果：新量表（成人多动症临床成果量表）的心理测量学。","authors":"Dimitrios Adamis, Jasmin Singh, Iulian Coada, Margo Wrigley, Blánaid Gavin, Fiona McNicholas","doi":"10.1192/bjo.2024.739","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Adult attention-deficit hyperactivity disorder (ADHD) clinics are in their infancy in Ireland and internationally. There is an urgent need for clinical evaluation of these services. Until now, clinical outcomes have relied mainly on functional scales and/or quality of life. However, adult ADHD is a longstanding disorder with many comorbidities. Although medication for ADHD symptoms can have immediate effects, co-occurring problems may take considerably longer to remediate.</p><p><strong>Aims: </strong>To present the psychometrics of a short outcome measure of key clinical areas including symptoms.</p><p><strong>Method: </strong>The ADHD Clinical Outcome Scale (ACOS), developed by the authors, is a clinician-rated scale and was administered in consecutive adults attending an ADHD clinic. A modified version was completed by the participant. A second clinician independently administered the scale in a subsample. ACOS consists of 15 items rated on a Likert scale. Two self-report scales, the Adult ADHD Quality of Life Questionnaire (AAQoL) and Weiss Functional Impairment Rating Scale (WFIRS), were also administered.</p><p><strong>Results: </strong>The mean age of 148 participants was 30.1 years (s.d. = 9.71), and 81 were female (54.7%). The correlation for interrater reliability was <i>r</i> = 0.868, and that between the participant and clinician versions was <i>r</i> = 0.663. The intraclass correlation coefficient for the internal consistency was 0.829, and the correlations for concurrent validity with total AAQoL and WFIRS scores were <i>r</i> = -0.573 and <i>r</i> = 0.477, respectively. Factor analysis revealed four factors: (a) attentional/organisational problems; (b) hyperactivity/impulsivity; (c) comorbidities; and (d) alcohol/drug use, self-harm and tension in relationships.</p><p><strong>Conclusions: </strong>The psychometrics of the ACOS are promising, and the inclusion of typically co-occurring clinical domains makes it suitable for use as a clinician-rated outcome measure in every contact with patients attending adult ADHD clinics.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"10 6","pages":"e180"},"PeriodicalIF":3.9000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Measuring clinical outcomes in adult ADHD clinics: psychometrics of a new scale, the adult ADHD Clinical Outcome Scale.\",\"authors\":\"Dimitrios Adamis, Jasmin Singh, Iulian Coada, Margo Wrigley, Blánaid Gavin, Fiona McNicholas\",\"doi\":\"10.1192/bjo.2024.739\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Adult attention-deficit hyperactivity disorder (ADHD) clinics are in their infancy in Ireland and internationally. There is an urgent need for clinical evaluation of these services. Until now, clinical outcomes have relied mainly on functional scales and/or quality of life. However, adult ADHD is a longstanding disorder with many comorbidities. Although medication for ADHD symptoms can have immediate effects, co-occurring problems may take considerably longer to remediate.</p><p><strong>Aims: </strong>To present the psychometrics of a short outcome measure of key clinical areas including symptoms.</p><p><strong>Method: </strong>The ADHD Clinical Outcome Scale (ACOS), developed by the authors, is a clinician-rated scale and was administered in consecutive adults attending an ADHD clinic. A modified version was completed by the participant. A second clinician independently administered the scale in a subsample. ACOS consists of 15 items rated on a Likert scale. Two self-report scales, the Adult ADHD Quality of Life Questionnaire (AAQoL) and Weiss Functional Impairment Rating Scale (WFIRS), were also administered.</p><p><strong>Results: </strong>The mean age of 148 participants was 30.1 years (s.d. = 9.71), and 81 were female (54.7%). The correlation for interrater reliability was <i>r</i> = 0.868, and that between the participant and clinician versions was <i>r</i> = 0.663. The intraclass correlation coefficient for the internal consistency was 0.829, and the correlations for concurrent validity with total AAQoL and WFIRS scores were <i>r</i> = -0.573 and <i>r</i> = 0.477, respectively. 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引用次数: 0
摘要
背景：成人注意缺陷多动障碍（ADHD）诊所在爱尔兰和国际上都处于起步阶段。目前迫切需要对这些服务进行临床评估。迄今为止，临床结果主要依赖于功能量表和/或生活质量。然而，成人多动症是一种长期存在的疾病，有许多并发症。尽管针对多动症症状的药物治疗可以产生立竿见影的效果，但同时存在的问题可能需要更长的时间才能得到缓解。目的：介绍一种针对包括症状在内的关键临床领域的简短结果测量方法的心理测量学：ADHD临床结果量表（ACOS）由作者开发，是一种由临床医生评分的量表，对连续到ADHD诊所就诊的成年人进行测量。参与者填写修改版。第二名临床医生对一个子样本进行独立施测。ACOS 由 15 个项目组成，采用李克特量表评分。此外，还采用了两个自我报告量表，即成人多动症生活质量问卷（AAQoL）和韦氏功能损伤评定量表（WFIRS）：148 名参与者的平均年龄为 30.1 岁（s.d. = 9.71），其中 81 人为女性（54.7%）。研究者之间的相关性为 r = 0.868，研究者版本和临床医生版本之间的相关性为 r = 0.663。内部一致性的类内相关系数为 0.829，与 AAQoL 和 WFIRS 总分的并发效度相关系数分别为 r = -0.573 和 r = 0.477。因子分析显示了四个因子：(a) 注意力/组织问题；(b) 多动/冲动；(c) 合并症；(d) 酗酒/吸毒、自残和人际关系紧张：结论：ACOS 的心理测量结果很有希望，它包含了典型的并发临床领域，因此适合在成人多动症诊所与患者的每次接触中用作临床医生评定的结果测量。
Measuring clinical outcomes in adult ADHD clinics: psychometrics of a new scale, the adult ADHD Clinical Outcome Scale.
Background: Adult attention-deficit hyperactivity disorder (ADHD) clinics are in their infancy in Ireland and internationally. There is an urgent need for clinical evaluation of these services. Until now, clinical outcomes have relied mainly on functional scales and/or quality of life. However, adult ADHD is a longstanding disorder with many comorbidities. Although medication for ADHD symptoms can have immediate effects, co-occurring problems may take considerably longer to remediate.
Aims: To present the psychometrics of a short outcome measure of key clinical areas including symptoms.
Method: The ADHD Clinical Outcome Scale (ACOS), developed by the authors, is a clinician-rated scale and was administered in consecutive adults attending an ADHD clinic. A modified version was completed by the participant. A second clinician independently administered the scale in a subsample. ACOS consists of 15 items rated on a Likert scale. Two self-report scales, the Adult ADHD Quality of Life Questionnaire (AAQoL) and Weiss Functional Impairment Rating Scale (WFIRS), were also administered.
Results: The mean age of 148 participants was 30.1 years (s.d. = 9.71), and 81 were female (54.7%). The correlation for interrater reliability was r = 0.868, and that between the participant and clinician versions was r = 0.663. The intraclass correlation coefficient for the internal consistency was 0.829, and the correlations for concurrent validity with total AAQoL and WFIRS scores were r = -0.573 and r = 0.477, respectively. Factor analysis revealed four factors: (a) attentional/organisational problems; (b) hyperactivity/impulsivity; (c) comorbidities; and (d) alcohol/drug use, self-harm and tension in relationships.
Conclusions: The psychometrics of the ACOS are promising, and the inclusion of typically co-occurring clinical domains makes it suitable for use as a clinician-rated outcome measure in every contact with patients attending adult ADHD clinics.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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