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

on behalf of the WHO World Mental Health Survey Collaborators

doi:10.1007/s12402-016-0208-3

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

on behalf of the WHO World Mental Health Survey Collaborators

Mailman School of Public Health

Producción científica › revisión exhaustiva

523 Citas (Scopus)

Resumen

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.

Idioma original	English
Páginas (desde-hasta)	47-65
Número de páginas	19
Publicación	ADHD Attention Deficit and Hyperactivity Disorders
Volumen	9
N.º	1
DOI	https://doi.org/10.1007/s12402-016-0208-3
Estado	Published - mar. 1 2017

Financiación

This work was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative which is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. A complete list of all within-country and cross-national WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/ . The Colombian National Study of Mental Health (NSMH) is supported by the Ministry of Social Protection. The Mental Health Study Medellín–Colombia was carried out and supported jointly by the Center for Excellence on Research in Mental Health (CES University) and the Secretary of Health of Medellín. The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123, and EAHC 20081308), the Piedmont Region (Italy)), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP), and other local agencies and by an unrestricted educational grant from GlaxoSmithKline. Implementation of the Iraq Mental Health Survey (IMHS) and data entry were carried out by the staff of the Iraqi MOH and MOP with direct support from the Iraqi IMHS team with funding from both the Japanese and European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF). The Lebanese National Mental Health Survey (LEBANON) is supported by the Lebanese Ministry of Public Health, the WHO (Lebanon), National Institute of Health / Fogarty International Center (R03 TW006481-01), Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences, anonymous private donations to IDRAAC, Lebanon, and unrestricted grants from AstraZeneca, Eli Lilly, GlaxoSmithKline, Hikma Pharmaceuticals, Janssen-Cilag, Lundbeck, Novartis, and Servier. The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544-H), with supplemental support from the Pan American Health Organization (PAHO). The Northern Ireland Study of Mental Health was funded by the Health & Social Care Research & Development Division of the Public Health Agency. The Peruvian World Mental Health Study was funded by the National Institute of Health of the Ministry of Health of Peru. The Polish project Epidemiology of Mental Health and Access to Care – EZOP Project (PL 0256) was supported by Iceland, Liechtenstein and Norway through funding from the EEA Financial Mechanism and the Norwegian Financial Mechanism. EZOP project was co-financed by the Polish Ministry of Health. The Portuguese Mental Health Study was carried out by the Department of Mental Health, Faculty of Medical Sciences, NOVA University of Lisbon, with collaboration of the Portuguese Catholic University, and was funded by Champalimaud Foundation, Gulbenkian Foundation, Foundation for Science and Technology (FCT) and Ministry of Health. The Romania WMH study projects “Policies in Mental Health Area” and “National Study regarding Mental Health and Services Use” were carried out by National School of Public Health & Health Services Management (former National Institute for Research & Development in Health, present National School of Public Health, Management & Professional Development, Bucharest), with technical support of Metro Media Transilvania, the National Institute of Statistics – National Centre for Training in Statistics, SC. Cheyenne Services SRL, Statistics Netherlands and were funded by Ministry of Public Health (former and present Ministry of Health) with supplemental support of Eli Lilly Romania SRL. The Psychiatric Enquiry to General Population in Southeast Spain–Murcia (PEGASUS-Murcia) Project has been financed by the Regional Health Authorities of Murcia (Servicio Murciano de Salud and Consejería de Sanidad y Política Social) and Fundación para la Formación e Investigación Sanitarias (FFIS) of Murcia. The Chinese World Mental Health Survey Initiative is supported by the Pfizer Foundation. The Shenzhen Mental Health Survey is supported by the Shenzhen Bureau of Health and the Shenzhen Bureau of Science, Technology, and Information. The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00204-3. The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044708), and the John W. Alden Trust.

Financiadores	Número del financiador
CONACyT-G30544-H
EEA Financial Mechanism
Eli Lilly Romania SRL
Gulbenkian Foundation
INPRFMDIES	4280
Iceland
Iraq Mental Health Survey
Liechtenstein and Norway
Mexican National Comorbidity Survey
Ministerio de Ciencia y Tecnología, Spain	SAF 2000-158-CE
Ministry of Social Protection
NOVA University of Lisbon
Norwegian Financial Mechanism
Ortho-McNeil Pharmaceutical
Portuguese Catholic University
Servicio Murciano de Salud and Consejería de Sanidad y Política Social
Shenzhen Bureau of Health
Shenzhen Bureau of Science, Technology, and Information
Shenzhen Mental Health Survey
São Paulo Megacity Mental Health Survey
UNDG
United Nations Development Group Iraq Trust Fund
WMH
World Health Organization World Mental Health
National Institutes of Health
National Institute of Mental Health	R01 MH070884, R01MH069864
National Institute on Drug Abuse
Substance Abuse and Mental Health Services Administration
Fogarty International Center	FIRCA R03-TW006481
Robert Wood Johnson Foundation	044708
John D. and Catherine T. MacArthur Foundation
John W. Alden Trust
Eli Lilly and Company
GlaxoSmithKline
Novartis
World Health Organization
U.S. Public Health Service	R01 DA016558, R13-MH066849, R01-MH069864
Pfizer Foundation
Pan American Health Organization
Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences
Cilag
Ministerio de Sanidad, Consumo y Bienestar Social
European Commission	QLG5-1999-01042, SANCO 2004123, EAHC 20081308
Public Health Agency
Fundação de Amparo à Pesquisa do Estado de São Paulo	03/00204-3, U01-MH60220
Fundação para a Ciência e a Tecnologia
Consejo Nacional de Ciencia y Tecnología
Ministry of Public Health
Instituto de Salud Carlos III	FIS 00/0028
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
Fundación para la Formación e Investigación Sanitarias de la Región de Murcia
Regione Piemonte
Departament de Salut, Generalitat de Catalunya	RETICS RD06/0011 REM-TAP, CB06/02/0046
H. Lundbeck A/S
Fundação Champalimaud
Ministerio de Salud	PL 0256

ASJC Scopus Subject Areas

Clinical Psychology
Psychiatry and Mental health

ODS de las Naciones Unidas

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@article{86344f277733469b907fd3dcbcb83dcd,

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.",

author = "{on behalf of the WHO World Mental Health Survey Collaborators} and John Fayyad and Sampson, {Nancy A.} and Irving Hwang and Tomasz Adamowski and Sergio Aguilar-Gaxiola and Ali Al-Hamzawi and Andrade, {Laura Helena Silveira Guerra} and Guilherme Borges and {de Girolamo}, Giovanni and Silvia Florescu and Oye Gureje and Haro, {Josep Maria} and Chiyi Hu and Karam, {Elie G.} and Sing Lee and Fernando Navarro-Mateu and Siobhan O{\textquoteright}Neill and Pennell, {Beth Ellen} and Marina Piazza and Jos{\'e} Posada-Villa and {ten Have}, Margreet and Yolanda Torres and Miguel Xavier and Zaslavsky, {Alan M.} and Kessler, {Ronald C.} and Mohammad Al-Kaisy and Subaie, {Abdullah Al} and Jordi Alonso and Yasmin Altwaijri and Lukoye Atwoli and Auerbach, {Randy P.} and Axinn, {William G.} and Corina Benjet and Bossarte, {Robert M.} and Bromet, {Evelyn J.} and Ronny Bruffaerts and Brendan Bunting and Ernesto Caffo and {de Almeida}, {Jose Miguel Caldas} and Graca Cardoso and Cia, {Alfredo H.} and Stephanie Chardoul and Somnath Chatterji and Filho, {Alexandre Chiavegatto} and Pim Cuijpers and Louisa Degenhardt and {de Graaf}, Ron and {de Jonge}, Peter and Koen Demyttenaere and Martins, {Silvia S.}",

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T1 - The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys

AU - on behalf of the WHO World Mental Health Survey Collaborators

AU - Fayyad, John

AU - Sampson, Nancy A.

AU - Hwang, Irving

AU - Adamowski, Tomasz

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi, Ali

AU - Andrade, Laura Helena Silveira Guerra

AU - Borges, Guilherme

AU - de Girolamo, Giovanni

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - Hu, Chiyi

AU - Karam, Elie G.

AU - Lee, Sing

AU - Navarro-Mateu, Fernando

AU - O’Neill, Siobhan

AU - Pennell, Beth Ellen

AU - Piazza, Marina

AU - Posada-Villa, José

AU - ten Have, Margreet

AU - Torres, Yolanda

AU - Xavier, Miguel

AU - Zaslavsky, Alan M.

AU - Kessler, Ronald C.

AU - Al-Kaisy, Mohammad

AU - Subaie, Abdullah Al

AU - Alonso, Jordi

AU - Altwaijri, Yasmin

AU - Atwoli, Lukoye

AU - Auerbach, Randy P.

AU - Axinn, William G.

AU - Benjet, Corina

AU - Bossarte, Robert M.

AU - Bromet, Evelyn J.

AU - Bruffaerts, Ronny

AU - Bunting, Brendan

AU - Caffo, Ernesto

AU - de Almeida, Jose Miguel Caldas

AU - Cardoso, Graca

AU - Cia, Alfredo H.

AU - Chardoul, Stephanie

AU - Chatterji, Somnath

AU - Filho, Alexandre Chiavegatto

AU - Cuijpers, Pim

AU - Degenhardt, Louisa

AU - de Graaf, Ron

AU - de Jonge, Peter

AU - Demyttenaere, Koen

AU - Martins, Silvia S.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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.

AB - 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.

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

Resumen

Financiación

ASJC Scopus Subject Areas

ODS de las Naciones Unidas

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