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: Tevfik Bedirhan Ustun, Oct 25, 2015
    • "Considering the studies that assess SAD comorbidity in ADHD patients, in a large epidemiological study, approximately 30% of the adults with ADHD received a diagnosis of comorbid SAD (Kessler et al., 2006). Park et al. (2011) have also found a relationship between adult ADHD and SAD comorbidity (odds ratio = 7.50). "
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    ABSTRACT: Abstract Objective: Our aim in this study is to evaluate the impacts of inattentive and combined types of childhood ADHD (ADHD-I, ADHD-C) in patients with social anxiety disorder (SAD). Methods: A total of 142 adult outpatients with a primary diagnosis of SAD were included. All patients were assessed by using the Structured Clinical Interview for DSMIV Axis I Disorders (SCID-I), Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version (K-SADS-PL), ADHD module and a clinical and sociodemographic data form and scales were filled out. Results: Childhood ADHD comorbidity rates was found to be 88 (62%) in patients with SAD, and 63 of these patients had the diagnosis of ADHD-I. ADHD-I group had higher scores of social anxiety and avoidance and had earlier onset of SAD than the ADHD-C group. Conclusion: The inattentive subtype of ADHD may have a more specific relationship with SAD than ADHD-C. (J. of Att. Dis. XXXX; XX(X) XX-XX)
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    • "According to Asherson et al. (2012), many adults with ADHD may underestimate the impact of ADHD symptoms and have learned to compensate for impairments by choosing lifestyles that help compensate for symptoms, which makes it difficult to diagnose the disorder and to calculate its prevalence. Nonetheless, epidemiological data estimate the prevalence of adult ADHD to be up to 5% (Faraone & Biederman, 2005; Fayyad et al., 2007; Kessler et al., 2006). Some studies carried out with college students from the United States have also shown that approximately 2% to 8% of the population report clinically significant levels of ADHD symptoms (Weyandt & DuPaul, 2006). "
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    ABSTRACT: Objective: This study explored the effect of cultural and gender differences in ADHD among Spanish, African American, Hispanic American, and European American young adults. Method: Structural equivalence between the four groups was examined by Tucker's phi coefficient. A MANCOVA was carried out with cultural groups and gender as factors and age as covariate. Results: Structural equivalence was observed across all groups, and no differential item functioning was found. No significant effect was found for gender, although, with the exception of the Hispanic group, males scored higher than females. Furthermore, small, though significant, cultural differences were found. The lowest levels of ADHD were observed in the European American group and the highest in the Hispanic American group. ADHD symptoms, notably inattention, showed some decline with age. Conclusion: Findings extend existing data and suggest a relationship between culture and the development of ADHD, which might be mediated by parenting style.
    No preview · Article · Oct 2015 · Journal of Attention Disorders
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    • "Twenty-one percent of children raised in institutions met criteria for attention deficit hyperactivity disorder (ADHD) by age 4½ years, even if they later lived in a foster care family (Zeanah et al. 2009); at 12 years the rate of ADHD was 19.3% (Humphreys et al. 2015). High rates of ADHD have also been observed in other studies of children reared in institutions (Kreppner et al. 2001; Stevens et al. 2008) and they are markedly higher than in never institutionalized children , where the prevalence of ADHD is estimated to be between 3% and 10% (Kessler et al. 2006; Spencer et al. 2007). Indeed, symptoms of ADHD are so common among previously institutionalized children, that some have argued that they represent one type of deprivation-specific behavior patterns (Kreppner et al. 2001; Rutter et al. 2010). "
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    ABSTRACT: Background: Young children raised in institutions are exposed to extreme psychosocial deprivation that is associated with elevated risk for psychopathology and other adverse developmental outcomes. The prevalence of attention deficit hyperactivity disorder (ADHD) is particularly high in previously institutionalized children, yet the mechanisms underlying this association are poorly understood. We investigated whether deficits in executive functioning (EF) explain the link between institutionalization and ADHD. Method: A sample of 136 children (aged 6-30 months) was recruited from institutions in Bucharest, Romania, and 72 never institutionalized community children matched for age and gender were recruited through general practitioners' offices. At 8 years of age, children's performance on a number of EF components (working memory, response inhibition and planning) was evaluated. Teachers completed the Health and Behavior Questionnaire, which assesses two core features of ADHD, inattention and impulsivity. Results: Children with history of institutionalization had higher inattention and impulsivity than community controls, and exhibited worse performance on working memory, response inhibition and planning tasks. Lower performances on working memory and response inhibition, but not planning, partially mediated the association between early institutionalization and inattention and impulsivity symptom scales at age 8 years. Conclusions: Institutionalization was associated with decreased EF performance and increased ADHD symptoms. Deficits in working memory and response inhibition were specific mechanisms leading to ADHD in previously institutionalized children. These findings suggest that interventions that foster the development of EF might reduce risk for psychiatric problems in children exposed to early deprivation.
    Full-text · Article · Oct 2015 · Psychological Medicine
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