The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication

Columbia University, New York, New York, United States
American Journal of Psychiatry (Impact Factor: 12.3). 05/2006; 163(4):716-23. DOI: 10.1176/appi.ajp.163.4.716
Source: PubMed


Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates.
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.
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.
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.

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Available from: Russell A Barkley, Jan 21, 2014
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    • "TBI may lead to psycho-neurological changes that in turn facilitate ADHD, or ADHD may increase the probability that an acute event (fall, crash, accident) will occur that will result in a TBI. Impulsive, hyperactive and inattentive tendencies can reflect both ADHD and TBI, and may be the reason why males have been found to experience both conditions more than females (Adeyemo et al., 2014; Bonfield et al., 2013; Kessler et al., 2006; Ilie et al., 2013, 2014a,b; Okie, 2006; Slomine et al., 2005; Thornhill et al., 2000; Weyandt and DuPaul, 2006; Zwi and Clamp, 2008). We observed that the odds of ADHD (either self-reported lifetime or current symptomatology) were greater among adults with lifetime brain injury even when we held constant values of sex, age, and education. "
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    ABSTRACT: Objective: This study describes the association between lifetime traumatic brain injury (TBI) and attention deficit and hyperactivity disorder (ADHD) among Canadian adults. Method: A cross-sectional sample of 3993 Ontario adults aged 18 or older were surveyed by Computer Assisted Telephone Interviewing (CATI) throughout 2011 and 2012 as part of the CAMH Monitor, a rolling survey assessing the health, mental health and substance use of Ontario adults. TBI was defined as trauma to the head that resulted in loss of consciousness for at leastfive minutes or overnight hospitalization. ADHD was measured by the 6-item ASRS screener for adult ADHD, and self-reported history of diagnosed ADHD. Results: Among adults with a history of TBI, 6.6% (95% CI: 4.7, 9.4) screened ADHD positive, and 5.9% (95% CI: 3.6, 9.5) reported having been diagnosed with ADHD in their lifetime. Adults with lifetime TBI had significantly greater odds of scoring positive on the ADHD/ASRS screen (OR¼ 2.49, 95% CI: 1.54, 4.04), and of reporting a history of diagnosed ADHD (OR¼ 2.64, 95% CI: 1.40, 4.98) than without TBI, when holding values of sex, age, and education constant. Conclusion: Significant positive associations between lifetime TBI and both current and past ADHD were observed among adults in this population. More research to understand these associations, and their significance for the etiology and management of TBI and ADHD, is needed
    Journal of Psychiatric Research 08/2015; DOI:10.1016/j.jpsychires.2015.08.004 · 3.96 Impact Factor
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    • "A large majority of patients endorsed symptoms of inattention, hyperactivity and/or impulsivity, and approximately half endorsed symptoms consistent with ADHD according to a liberal cutoff criterion on a self-report scale of ADHD. Although it should be emphasized that meeting the cutoff criterion on a single self-report scale of ADHD should in no way be considered diagnostic, this percentage is far greater than the rates of ADHD reported among adults with co-occurring disorders (Kessler et al., 2006). Fewer patients (i.e., approximately one-fourth) endorsed symptoms consistent with ADHD according to a conservative cutoff, suggesting that a higher cutoff criterion on the ADHD-SR may be needed when assessing patients with known psychological difficulties. "
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    ABSTRACT: The lack of specificity of attention-deficit/hyperactivity disorder (ADHD)symptoms represents a diagnostic challenge, especially when assessing psychiatric patients reporting awide range of complaints. Rate of endorsement ofADHDsymptoms, and their association with neuropsychological performance, was examined in a psychiatric sample of 71 adults, who had been referred for a neuropsychological evaluation. Patients completed two self-report measures of ADHD symptoms, the ADHD Self-Report Scale (ADHD-SR) and the Wender Utah Rating Scale-Short Form, as well as measures of attention, executive functioning, visuoconstructional ability, and verbal learning and memory. On the ADHD-SR, 74.6%of the sample met the cutoff for inattention or hyperactivity, while 81.7%met the cutoff for impulsivity. Neuropsychological performance was weakly associated with self-reported symptoms. Our results suggest that psychiatric patients commonly report symptoms of inattention, hyperactivity, and impulsivity. Assessment utilizing multiple sources is necessary to confirm whether self-reported symptoms are indicative of ADHD or reflect other causes.
    Archives of Clinical Neuropsychology 06/2015; DOI:10.1093/arclin/acv2015 · 1.99 Impact Factor
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    • "Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders, affecting 5.3% of children [Polanczyck et al., 2007] and 2.5–4.4% of adults worldwide [Kessler et al., 2006; Simon et al., 2009]. It is associated with a wide range of functional impairments across life domains and with higher incidence of other psychiatric disorders [Biederman et al., 2006; Kessler et al., 2006]. High heritability estimates (around 76–80%) have been indicated for ADHD, both in children [Faraone et al., 2005] and adults [Chang et al., 2013]. "
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    ABSTRACT: Dysfunctions of the dopaminergic system have been implicated on the etiology of Attention Deficit/Hyperactivity Disorder (ADHD). Meta-analyses addressing the association of the dopamine receptor D2 (DRD2) gene and ADHD were inconclusive due to excessive heterogeneity across studies. Both the great phenotypic heterogeneity of ADHD and the complexity of the genomic region where DRD2 is located could contribute to the inconsistent findings. Most previous DRD2 studies focused on the well-known Taq1A (rs1800497) SNP, which is actually placed in a neighbor gene (ANKK1). These two genes, together with NCAM1 and TTC12, form the NTAD gene cluster on Chr11q22-23. In order to address the reasons for the high heterogeneity previously reported on DRD2 effects on ADHD, this study investigates the role of NTAD variants on ADHD susceptibility in adults and on the modulation of comorbidity and personality profiles in these patients. Functional polymorphisms from NTAD were analyzed, both individually and in haplotypes, on a sample of 520 adults with ADHD and 630 non-ADHD controls. No direct association of NTAD variants with ADHD susceptibility itself was observed. However, different NTAD polymorphisms and haplotypes were associated to various phenotypes relevant to the clinical heterogeneity of ADHD, including Major Depressive Disorder, Generalized Anxiety Disorder, and Harm Avoidance and Persistence temperament scores. Therefore, these findings represent a possible explanation for the multiple conflicting findings regarding polymorphisms in this genomic region in psychiatry. The NTAD cluster may comprise a variety of independent molecular influences on various brain and behavior characteristics eventually associated with ADHD comorbidities and personality traits. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    American Journal of Medical Genetics Part B Neuropsychiatric Genetics 05/2015; 168(6):433-444. DOI:10.1002/ajmg.b.32317 · 3.42 Impact Factor
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