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 Helena 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, Jose Posada-VillaMargreet ten Have, Yolanda Torres, Miguel Xavier, Alan M. Zaslavsky, Ronald C. Kessler

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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 under-treated across countries and cultures.
Original languageEnglish
Pages (from-to)47-65
Number of pages19
JournalADHD Attention Deficit and Hyperactivity Disorders
Issue number1
Early online date19 Nov 2016
Publication statusPublished (in print/issue) - Mar 2017


  • ADHD
  • Attention-deficit/hyperactivity disorder
  • Comorbidity
  • Disability epidemiology
  • Impairment
  • Prevalence
  • Treatment


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