一分钟多动症测试
A One-Minute ADHD Test

原始链接: https://psychotechnology.substack.com/p/a-one-minute-adhd-test-2330

这篇文章介绍了一个出乎意料地有效的六问题多动症筛查测试。得分达到4分或以上,提示有很强的多动症可能性,并建议咨询精神科医生进行专业评估。作者在自我试验兴奋剂后发现了这个测试——发现它们提供了清晰度和专注力,促使他为自己进行多动症评估。 该测试具有69%的敏感性和99.5%的特异性,这意味着如果得分高于阈值,则有87.5%的几率准确识别多动症。多动症是可以有效治疗的,兴奋剂对70-90%的人来说非常有效,可以显著提高生活质量。非兴奋剂选项也可供选择。 虽然该测试并非完美——会遗漏一些病例,并且偶尔会误诊没有多动症的人——但它耗时少,信号强烈,是自我评估或帮助他人识别潜在的改变生活状况的疾病的有用工具。

一个ADHD一分钟测试的链接在Hacker News上被分享,引发了关于此类快速评估有效性的讨论。一位评论员指出,像“你多久感到X?”这样的问题带有主观性,认为“非常频繁”因人而异,可能导致不准确的自我诊断。他们还担心人们怀疑自己患有某种疾病时会夸大症状,以及不必要的筛查可能给医疗系统带来压力。 进一步的讨论涉及ADHD和自闭症的共病,一位用户指出美国的医疗系统面临更大的挑战。另一位评论员则认为文章中最值得关注的是测试本身。该讨论强调了自我诊断的复杂性以及简短在线问卷的局限性。
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原文

There is a six-question test for ADHD that takes a minute to complete. If you score highly on it, you are likely to have ADHD and have a strong reason to talk to a psychiatrist about getting medication. It’s a low-effort way to surface a real problem for yourself — or help someone else surface it.

Here’s the story of how I found the test. If you just want the test, skip this section.

A few years ago when I was moving from Moscow to London I had small leftover amounts of simulants 3-FMC and MDPV from my student days. I’d use them for productivity during exam periods, but I never actually enjoyed them recreationally. Still, I was not going to carry sketchy chemicals across two borders, so I figured I’d experiment with recreational use.

I snorted a small line of 3-FMC and instead of having fun I finally felt clearheaded enough to stop procrastinating on writing a farewell post for my then-colleagues. I knew stimulants are a common treatment for ADHD, so a question popped into my head: do I have ADHD? Yes, stimulants help everyone focus, but the contrast was too striking to ignore.

I took a few online tests, they did suggest ADHD. I then read more about ADHD online and that also suggested I had it. I kept reading and reading wanting full certainty.

There was only one definitive way to find out: get a diagnosis from a psychiatrist.

I was leaving Russia in a few weeks, and Russia bans first-line ADHD medications like amphetamine and methylphenidate. So I decided to wait until I moved to London. After two months after arriving in London, I booked a private assessment with a psychiatrist. Shortly after, I had the 1.5 hour assessment and walked out with an ADHD diagnosis and a prescription for lisdexamfetamine, a prodrug of d-amphetamine.

One of the questionnaires they sent me before the appointment was very short. I later learned that this six-question screener is surprisingly effective.

If you score 4 out 6 on the test above, you have a strong reason to suspect ADHD and get a proper assessment.

Just the six questions above have a sensitivity of 69% and specificity of 99.5% in the general population. This means:

If we assume 5% of people have ADHD (this source gives 4.4%, and this gives 6%), then:

  • The test would correctly pick up 3.5% of the population as having ADHD (0.69 × 5%).

  • It would incorrectly flag about 0.5% (≈0.475%, rounding up) of the population who don’t have ADHD.

So if you score 4 out of 6, the chance you actually have ADHD is:

3.5% / (3.5% + 0.5%) = 87.5%.

ADHD is highly treatable with meds. First-line treatments for ADHD — stimulants like amphetamine and methylphenidate — work really well. To quote a podcast on psychiatry: “Stimulants are one of the most effective meds in psychiatry” (source), ”Not many treatments in psychiatry have a large effect size. There’s stimulants for ADHD, ketamine for depression” (source).

70-90% of people with ADHD find stimulants effective and experience noticeable quality of life improvements.

And if you don’t want to take stimulants or they don’t work for you, there are non-stimulant medications, such as atomoxetine or Intuniv.

This test is an imperfect screening tool that misses a third of all true ADHD cases and incorrectly flags a small percentage of non-ADHD people. But it has an incredible signal to effort ratio — it only takes a minute to take. If you score above its threshold — you have a strong reason to seek a full assessment.

Even if you are confident you don’t have ADHD, it’d only take you a minute to test your distractible friend. The right medication could be life-changing for them — it certainly was for me.

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