The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys

Atten Defic Hyperact Disord. 2017 Mar;9(1):47-65. doi: 10.1007/s12402-016-0208-3. Epub 2016 Nov 19.

Abstract

We previously reported on the cross-national epidemiology of ADHD from the first 10 countries in the WHO World Mental Health (WMH) Surveys. The current report expands those previous findings to the 20 nationally or regionally representative WMH surveys that have now collected data on adult ADHD. The Composite International Diagnostic Interview (CIDI) was administered to 26,744 respondents in these surveys in high-, upper-middle-, and low-/lower-middle-income countries (68.5% mean response rate). Current DSM-IV/CIDI adult ADHD prevalence averaged 2.8% across surveys and was higher in high (3.6%)- and upper-middle (3.0%)- than low-/lower-middle (1.4%)-income countries. Conditional prevalence of current ADHD averaged 57.0% among childhood cases and 41.1% among childhood subthreshold cases. Adult ADHD was significantly related to being male, previously married, and low education. Adult ADHD was highly comorbid with DSM-IV/CIDI anxiety, mood, behavior, and substance disorders and significantly associated with role impairments (days out of role, impaired cognition, and social interactions) when controlling for comorbidities. Treatment seeking was low in all countries and targeted largely to comorbid conditions rather than to ADHD. These results show that adult ADHD is prevalent, seriously impairing, and highly comorbid but vastly under-recognized and undertreated across countries and cultures.

Keywords: ADHD; Attention-deficit/hyperactivity disorder; Comorbidity; Disability epidemiology; Impairment; Prevalence; Treatment.

MeSH terms

  • Adolescent
  • Adult
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Comorbidity
  • Developed Countries / statistics & numerical data
  • Developing Countries / statistics & numerical data
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Health Surveys*
  • Humans
  • Income
  • Male
  • Mental Disorders / epidemiology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prevalence
  • Risk Factors
  • World Health Organization*
  • Young Adult