The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD?
The differential diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood is complicated by comorbid disorders, but also by the overlapping of main symptoms such as inattentiveness, impulsivity, and hyperactivity with other disorders. Neuropsychological tests like continuous perform...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00216/full |
| _version_ | 1818446569108668416 |
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| author | Nathalie Brunkhorst-Kanaan Moritz Verdenhalven Sarah Kittel-Schneider Sarah Kittel-Schneider Isabella Vainieri Andreas Reif Oliver Grimm |
| author_facet | Nathalie Brunkhorst-Kanaan Moritz Verdenhalven Sarah Kittel-Schneider Sarah Kittel-Schneider Isabella Vainieri Andreas Reif Oliver Grimm |
| author_sort | Nathalie Brunkhorst-Kanaan |
| collection | DOAJ |
| description | The differential diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood is complicated by comorbid disorders, but also by the overlapping of main symptoms such as inattentiveness, impulsivity, and hyperactivity with other disorders. Neuropsychological tests like continuous performance tests (CPT) try to solve this dilemma by objectively measurable parameters. We investigated in a cohort of n=114 patients presenting to an ADHD outpatient clinic how well a commercially available CPT test (QbTest®) can differentiate between patients with ADHD (n=94) and patients with a disconfirmed ADHD diagnosis (n=20). Both groups showed numerous comorbidities, predominantly depression (27.2% in the ADHD group vs. 45% in the non-ADHD group) and substance-use disorders (18.1% vs. 10%, respectively). Patients with ADHD showed significant higher activity (2.07 ± 1.23) than patients without ADHD (1.34 ± 1.27, dF=112; p=0.019), whereas for the other core parameters, inattention and impulsivity no differences could be found. Reaction time variability has been discussed as a typical marker for inattention in ADHD. Therefore, we investigated how well ex-Gaussian analysis of response time can differentiate between ADHD and other patients, showing, that it does not help to identify patients with ADHD. Even though patients with ADHD showed significantly higher activity, this parameter differed only poorly between patients (accuracy AUC 65% of an ROC-Curve). We conclude that CPTs do not help to identify patients with ADHD in a specialized outpatient clinic. The usability of this test for differentiating between ADHD and other psychiatric disorders is poor and a sophisticated analysis of reaction time did not decisively increase the test accuracy. |
| first_indexed | 2024-12-14T19:49:48Z |
| format | Article |
| id | doaj.art-faab62faad9c4a3497fa2c9d5e71816e |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-14T19:49:48Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-faab62faad9c4a3497fa2c9d5e71816e2022-12-21T22:49:27ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-03-011110.3389/fpsyt.2020.00216501554The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD?Nathalie Brunkhorst-Kanaan0Moritz Verdenhalven1Sarah Kittel-Schneider2Sarah Kittel-Schneider3Isabella Vainieri4Andreas Reif5Oliver Grimm6Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, GermanyDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, GermanyDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, GermanyDepartment of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital, University of Würzburg, Würzburg, GermanySocial, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United KingdomDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, GermanyDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, GermanyThe differential diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood is complicated by comorbid disorders, but also by the overlapping of main symptoms such as inattentiveness, impulsivity, and hyperactivity with other disorders. Neuropsychological tests like continuous performance tests (CPT) try to solve this dilemma by objectively measurable parameters. We investigated in a cohort of n=114 patients presenting to an ADHD outpatient clinic how well a commercially available CPT test (QbTest®) can differentiate between patients with ADHD (n=94) and patients with a disconfirmed ADHD diagnosis (n=20). Both groups showed numerous comorbidities, predominantly depression (27.2% in the ADHD group vs. 45% in the non-ADHD group) and substance-use disorders (18.1% vs. 10%, respectively). Patients with ADHD showed significant higher activity (2.07 ± 1.23) than patients without ADHD (1.34 ± 1.27, dF=112; p=0.019), whereas for the other core parameters, inattention and impulsivity no differences could be found. Reaction time variability has been discussed as a typical marker for inattention in ADHD. Therefore, we investigated how well ex-Gaussian analysis of response time can differentiate between ADHD and other patients, showing, that it does not help to identify patients with ADHD. Even though patients with ADHD showed significantly higher activity, this parameter differed only poorly between patients (accuracy AUC 65% of an ROC-Curve). We conclude that CPTs do not help to identify patients with ADHD in a specialized outpatient clinic. The usability of this test for differentiating between ADHD and other psychiatric disorders is poor and a sophisticated analysis of reaction time did not decisively increase the test accuracy.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00216/fullADHDADHD differential diagnosisex-Gaussian analysiscontinuous performance testQbTest®naturalistic sample |
| spellingShingle | Nathalie Brunkhorst-Kanaan Moritz Verdenhalven Sarah Kittel-Schneider Sarah Kittel-Schneider Isabella Vainieri Andreas Reif Oliver Grimm The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? Frontiers in Psychiatry ADHD ADHD differential diagnosis ex-Gaussian analysis continuous performance test QbTest® naturalistic sample |
| title | The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? |
| title_full | The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? |
| title_fullStr | The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? |
| title_full_unstemmed | The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? |
| title_short | The Quantified Behavioral Test—A Confirmatory Test in the Diagnostic Process of Adult ADHD? |
| title_sort | quantified behavioral test a confirmatory test in the diagnostic process of adult adhd |
| topic | ADHD ADHD differential diagnosis ex-Gaussian analysis continuous performance test QbTest® naturalistic sample |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00216/full |
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