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

  • John Fayyad
  • Nancy A. Sampson
  • Irving Hwang
  • Tomasz Adamowski
  • Sergio Aguilar-Gaxiola
  • Ali Al-Hamzawi
  • Laura H. S. G. Andrade
  • Guilherme Borges
  • Giovanni de Girolamo
  • Silvia Florescu
  • Oye Gureje
  • Josep Maria Haro
  • Chiyi Hu
  • Elie G. Karam
  • Sing Lee
  • Fernando Navarro-Mateu
  • Siobhan O’Neill
  • Beth-Ellen Pennell
  • Marina Piazza
  • José Posada-Villa
  • Margreet ten Have
  • Yolanda Torres
  • Miguel Xavier
  • Alan M. Zaslavsky
  • Ronald C. Kessler
  • on behalf of the WHO World Mental Health Survey Collaborators
Original Article

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 

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • John Fayyad
    • 1
  • Nancy A. Sampson
    • 2
  • Irving Hwang
    • 2
  • Tomasz Adamowski
    • 3
  • Sergio Aguilar-Gaxiola
    • 4
  • Ali Al-Hamzawi
    • 5
  • Laura H. S. G. Andrade
    • 6
  • Guilherme Borges
    • 7
  • Giovanni de Girolamo
    • 8
  • Silvia Florescu
    • 9
  • Oye Gureje
    • 10
  • Josep Maria Haro
    • 11
  • Chiyi Hu
    • 12
    • 13
  • Elie G. Karam
    • 1
    • 14
    • 15
  • Sing Lee
    • 16
  • Fernando Navarro-Mateu
    • 17
  • Siobhan O’Neill
    • 18
  • Beth-Ellen Pennell
    • 19
  • Marina Piazza
    • 20
    • 21
  • José Posada-Villa
    • 22
  • Margreet ten Have
    • 23
  • Yolanda Torres
    • 24
  • Miguel Xavier
    • 25
  • Alan M. Zaslavsky
    • 2
  • Ronald C. Kessler
    • 2
  • on behalf of the WHO World Mental Health Survey Collaborators
  1. 1.Institute for Development, Research, Advocacy and Applied Care (IDRAAC)BeirutLebanon
  2. 2.Department of Health Care PolicyHarvard Medical SchoolBostonUSA
  3. 3.Department of Nervous System Diseases, Faculty of Health ScienceMedical University of WroclawWroclawPoland
  4. 4.Center for Reducing Health DisparitiesUC Davis Health SystemSacramentoUSA
  5. 5.College of MedicineAl-Qadisiya UniversityDiwaniya GovernorateIraq
  6. 6.Section of Psychiatric Epidemiology-LIM 23, Institute of PsychiatryUniversity of São Paulo Medical SchoolSão PauloBrazil
  7. 7.Instituto Nacional de Psiquiatria Ramon de la Fuente MuñizMexicoMexico
  8. 8.IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio FatebenefratelliBresciaItaly
  9. 9.National School of Public Health, Management and Professional DevelopmentBucharestRomania
  10. 10.Department of PsychiatryUniversity College HospitalIbadanNigeria
  11. 11.Parc Sanitari Sant Joan de Déu, CIBERSAMUniversitat de BarcelonaBarcelonaSpain
  12. 12.Shenzhen Institute of Mental HealthShenzhenChina
  13. 13.Shenzhen Kangning HospitalShenzhenChina
  14. 14.Department of Psychiatry and Clinical Psychology, Faculty of MedicineBalamand UniversityBeirutLebanon
  15. 15.Department of Psychiatry and Clinical PsychologySt George Hospital University Medical CenterBeirutLebanon
  16. 16.Department of PsychiatryChinese University of Hong KongTai PoHong Kong
  17. 17.IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia PsiquiátricaServicio Murciano de SaludMurciaSpain
  18. 18.School of PsychologyUniversity of UlsterLondonderryUK
  19. 19.Institute for Social ResearchUniversity of MichiganAnn ArborUSA
  20. 20.National Institute of HealthLimaPeru
  21. 21.Universidad Peruana Cayetano HerediaLimaPeru
  22. 22.El Bosque UniversityBogotaColombia
  23. 23.Trimbos-Instituut, Netherlands Institute of Mental Health and AddictionUtrechtNetherlands
  24. 24.Center for Excellence on Research in Mental HealthCES UniversityMedellinColombia
  25. 25.Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências MédicasUniversidade Nova de LisboaLisbonPortugal

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