[Evaluation of the validity of AD/HD diagnoses in referrals from paediatrics to the child psychiatry clinic].

OBJECTIVES: To evaluate the validity of clinical diagnoses of attention deficit/hyperactivity disorder (AD/HD).

DESIGN: Descriptive, cross-sectional study.

SETTING: Mental Health Care area 6, Murcia, Spain.

PARTICIPANTS: The sample consists of those patients referred consecutively to the child psychiatry clinic between July and September 2005.

MAIN MEASUREMENTS: The presumptive diagnosis of AD/HD in the paediatric department referral was compared with the definitive one in psychiatry (gold standard). Sensitivity, specificity and predictive values and probability quotients were calculated.

RESULTS: Seventy-five patients were included; 12% were lost. Sixty-six cases were studied, 15 with AD/HD and 51 with other diagnoses (23 with differential diagnoses from AD/HD). Sensitivity was 86.7% (95% CI, 69.5-100); specificity, 54.9% (95% CI, 41.3-68.6); positive predictive value, 36.1% (95% CI, 20.4-51.8); and negative predictive value, 93.3% (95% CI, 84.4-100).

CONCLUSIONS: Validity of diagnosis was moderate with high sensitivity, low specificity and a low positive predictive value, the latter calculated for low AD/HD prevalence. The clinical picture of AD/HD tends to be oversized. The presumptive diagnosis in primary care behaved as a screening test. The clinical diagnosis in primary care should be complemented with other diagnostic tests that provide greater specificity.