Ask the patient: how often have they been bothered by the following over the past 2 weeks?

1. . How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?

2. How often do you have difficulty getting things in order when you have to do a task that requires organization?

3. How often do you have problems remembering appointments or obligations?

4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

5. . How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?

6. How often do you feel overly active and compelled to do things, like you were driven by a motor?

7. How often do you make careless mistakes when you have to work on boring or difficult projects?

8. How often do you have difficulty keeping your attention when you are doing boring or repitive work?

9. How often do you have difficulty on what people say to you, even when they are speaking directly to you?

10. How often do you misplace or have difficulty finding things at home or at work?

11. How often are you distracted by activity or noise around you?

12. How often do you have to leave your seat in meetings or other situations in which you expected to remain seated?

13. How often do you feel restless or fidgety?

14. How often do you have difficulty unwinding and relaxing when you have time to yourself?

15. How often do you find talking too much when you are in socal sitautions?

16. When you are in conversation, how often do you find yourself finishing the sentences of this people you are talking to before they can finish themselves?

17. How often do you have difficulty waiting in turn in situations when turn taking is required

18. How often do you interrupt others when they are busy?

0

Points

Scores ≤4 are less likely to be consistent with Adult ADHD.

ADVICE

A diagnosis of Adult ADHD should be based on a comprehensive clinical assessment, including a structured interview, self-reported symptoms, and evaluation of functional impairment across multiple domains (e.g., work, home, relationships).

MANAGEMENT

Adult ADHD Symptom Severity Summary
Score ADHD Severity Comments
0–9 Low Unlikely to indicate ADHD; no treatment typically required.
10–13 Mild to Moderate May indicate ADHD; consider further clinical evaluation.
14–17 High Likely indication of ADHD; clinical confirmation and treatment planning recommended.
18+ Very High Strong indication of ADHD; comprehensive assessment and active treatment advised.

CRITICAL ACTIONS

  • Perform suicide risk assessment in patients who respond positively to item 9 “Thoughts that you would be better off dead or of hurting yourself in some way.”
  • Rule out bipolar disorder, normal bereavement, and medical disorders causing depression.

FORMULA

Total score is calculated by summing the selected responses across the assessment items.

FACTS & FIGURES

The Adult ADHD Self-Report Scale (ASRS) is a validated screening tool developed by the World Health Organization (WHO) to assess symptoms consistent with Attention-Deficit/Hyperactivity Disorder in adults. It includes questions that map directly to DSM criteria for ADHD and is commonly used in both clinical and research settings.

EVIDENCE APPRAISAL

The ASRS was developed in conjunction with the WHO Composite International Diagnostic Interview (CIDI) and validated in a large population-based sample. The 6-item ASRS Screener was found to have strong psychometric properties, with high sensitivity (68.7%) and specificity (99.5%) for ADHD diagnosis (Kessler et al., 2005).

Studies have shown the ASRS to be effective in identifying ADHD symptoms across diverse populations, including college students, working adults, and patients in primary care settings. It has also been used internationally and translated into multiple languages with consistent reliability and validity.

While a positive screening result on the ASRS suggests a high likelihood of ADHD, diagnosis should always be confirmed through a comprehensive clinical interview, including evaluation of symptom history, functional impairment, and exclusion of alternative diagnoses.