Assessing Adult ADHD in Tabriz, Northwestern Iran: Insights from Online Screening and Clinical Diagnosis

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) may persist into adulthood. Although online adult ADHD screening represents a novel and low-cost technique, its feasibility has not been well studied in Iran. Objectives: The present study aimed to assess the prevalence of adult ADHD in Tabriz, Iran, using online screening and clinical diagnosis. Methods: This cross-sectional study was conducted in Tabriz during the second half of 2018. The target population comprised all outpatients referred to Asadabadi Hospital. Through banners and public advertisements at the hospital entrance, all outpatients were invited to participate in the ADHD online screening project. The study utilized Adult Conners Self-Reporting Scale (CAAS-S: SV) for online screening over a 6-month period in 2018. Online screening results were compared with psychiatric interviews as the gold standard. Data analysis was performed using independent t-test, analysis of variance (ANOVA), Fisher’s exact test, and chi-square test in SPSS software version 21.0. Results: Out of 799 individuals who participated through the website to report adult ADHD symptoms, 462 met the inclusion criteria and were enrolled in the study. Among these 462 screened individuals, 165 (35.71%) tested positive for ADHD. Of the 462 participants, 69 attended clinical assessment, revealing a 56.53% ADHD prevalence based on psychiatric diagnosis. There were no significant differences between ADHD and gender or between ADHD and age. However, a significant difference in D-Index scores was observed between the 19 - 29 and 30 - 39 age groups. A significant association was found between ADHD and a family history of ADHD, but no significant association was observed between ADHD and psychiatric comorbidities. The online screening demonstrated 84.61% sensitivity and 66.67% specificity compared to the psychiatric interview. Conclusions: The online screening demonstrated good sensitivity (84.61%) and moderate specificity (66.67%) for detecting adult ADHD. This approach can contribute to reducing presentations to psychiatrists and may be particularly useful during epidemics.