title: The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys.
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.
authors.affiliation: Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon. jfayyad@idraac.org.
authors.forename: John
authors.initials: J
authors.lastname: Fayyad
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Nervous System Diseases, Faculty of Health Science, Medical University of Wroclaw, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Adamowski
authors.affiliation: Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.affiliation: College of Medicine, Al-Qadisiya University, Diwaniya Governorate, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Hamzawi
authors.affiliation: Section of Psychiatric Epidemiology-LIM 23, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Laura H S G
authors.initials: LH
authors.lastname: Andrade
authors.affiliation: Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico, DF, Mexico.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.affiliation: IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.affiliation: Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Shenzhen Institute of Mental Health, Shenzhen, China.|Shenzhen Kangning Hospital, Shenzhen, China.
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.|Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon.|Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon.
authors.forename: Elie G
authors.initials: EG
authors.lastname: Karam
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong.
authors.forename: Sing
authors.initials: S
authors.lastname: Lee
authors.affiliation: IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar, Murcia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
authors.affiliation: School of Psychology, University of Ulster, Londonderry, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Beth-Ellen
authors.initials: BE
authors.lastname: Pennell
authors.affiliation: National Institute of Health, Lima, Peru.|Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Marina
authors.initials: M
authors.lastname: Piazza
authors.affiliation: El Bosque University, Bogota, Colombia.
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.affiliation: Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Ten Have
authors.affiliation: Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Torres
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Xavier
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D015897:Comorbidity; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D014944:World Health Organization; D055815:Young Adult
keywords: ADHD; Attention-deficit/hyperactivity disorder; Comorbidity; Disability epidemiology; Impairment; Prevalence; Treatment