Résumé
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.
Langue d'origine | English |
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Pages (de-à) | 47-65 |
Nombre de pages | 19 |
Journal | ADHD Attention Deficit and Hyperactivity Disorders |
Volume | 9 |
Numéro de publication | 1 |
DOI | |
Statut de publication | Published - mars 1 2017 |
Financement
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.
Bailleurs de fonds | Numéro du bailleur de fonds |
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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