The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication.
OBJECTIVE
Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates.


METHODS
A screen for adult ADHD was included in a probability subsample (N=3,199) of 18-44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-administered diagnostic interview to assess a wide range of DSM-IV disorders. Blinded clinical follow-up interviews of adult ADHD were carried out with 154 respondents, oversampling those with positive screen results. Multiple imputation was used to estimate prevalence and correlates of clinician-assessed adult ADHD.


RESULTS
The estimated prevalence of current adult ADHD was 4.4%. Significant correlates included being male, previously married, unemployed, and non-Hispanic white. Adult ADHD was highly comorbid with many other DSM-IV disorders assessed in the survey and was associated with substantial role impairment. The majority of cases were untreated, although many individuals had obtained treatment for other comorbid mental and substance-related disorders.


CONCLUSIONS
Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD.
Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA. kessler@hcp.med.harvard.edu
Ronald C
RC
Kessler
Lenard
L
Adler
Russell
R
Barkley
Joseph
J
Biederman
C Keith
CK
Conners
Olga
O
Demler
Stephen V
SV
Faraone
Laurence L
LL
Greenhill
Mary J
MJ
Howes
Kristina
K
Secnik
Thomas
T
Spencer
T Bedirhan
TB
Ustun
Ellen E
EE
Walters
Alan M
AM
Zaslavsky
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D014478:Unemployment / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data