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Visual Abstract

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

How common is adult ADHD?

Ronald C Kessler, Lenard Adler, Russell Barkley, Joseph Biederman, C Keith Conners, Olga Demler, Stephen V Faraone, Laurence L Greenhill, Mary J Howes, Kristina Secnik, Thomas Spencer, T Bedirhan Ustun, Ellen E Walters, Alan M Zaslavsky
Summarized by:
Charles Li, MD
April 22, 2023
study source
American Journal of Psychiatry
April 2006

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Researchers conducted a nationwide survey in the United States to see how common adult ADHD was and what factors it correlated with.
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ADHD was particularly common among men, non-Hispanic white people, the unemployed, and the previously married.
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Adult ADHD is also significantly undertreated, even though it can seriously impact someone's career and personal life.

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

Background

This study was conducted to help gather more information on adult ADHD. Adult ADHD has not always been widely recognized as a legitimate psychiatric condition.

Before the study was conducted, there was not as much information available on how common adult ADHD was. There was also a need to get more information on what other factors ADHD correlated with.

For example, researchers wanted to know whether adult ADHD is linked with other mental health conditions.

Study Quote
Kessler et al

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

Method

Researchers conducted a study with a national survey, followed by interviews with those with ADHD.

The national survey came from a group that was designed to be representative of the United States as a whole.

To estimate ADHD rates, researchers asked participants to recall whether they had specific symptoms of ADHD when they were children and to describe whether they still had the symptoms as adults. This was not meant to be a comprehensive evaluation of ADHD, but the method helps provide population-level estimates.

Researchers used structured interviews and surveys to estimate whether ADHD was correlated with other factors, such as mental health conditions.

Study Quote
Kessler et al

Method: 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 ...

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Results

Researchers found that around 4.4% of adults may have ADHD. This number is slightly higher than other studies that show a prevalence of around 2.5%. However, estimates of ADHD prevalence are notoriously wide-ranged.

One of the most significant risk factors for developing ADHD was gender. Men are approximately 60% more likely to have ADHD than women.

A nationwide survey in the United States estimated that men have significantly higher odds of developing ADHD.

Non-Hispanic White people were also more likely to develop ADHD than other races. For example, they were three times more likely to develop ADHD than Hispanic or Black participants:

A nationwide survey found that Hispanic and Black Americans are significantly less likely to develop ADHD than non-Hispanic White Americans.

Some of the other strong risk factors found were marriage and employment status. Those who were divorced or unemployed were around twice as likely to have adult ADHD.

As with all similar survey studies, correlation doesn’t imply causation. However, based on what we know about ADHD, these findings support the theory that ADHD negatively impacts careers and marriage.

Individuals who were either divorced or unemployed were around twice as likely to have ADHD.

Those with ADHD were also more likely to suffer from other psychiatric disorders.

Some diagnoses highly correlated with ADHD were social phobia and generalized anxiety disorder.

This study estimated that someone with ADHD is around 3-5x more likely to develop these disorders than someone without ADHD.

Common Disorders in ADHD

Overall, when looking at types of disorders common in ADHD, we can see that mood disorders in general, such as Bipolar Disorder and Depression, are the most common, with anxiety disorders not far behind.

ADHD and Psychiatric Comorbidity

It’s important to note that most of the ADHD cases found in this study were untreated at the time. Some did receive treatments for other conditions they may have had, but most did not receive specific treatment for their ADHD.

This suggests that ADHD is significantly underdiagnosed and under-treated in the United States.

Study Quote
Kessler et al

Results: 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...

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Conclusions

Adult ADHD is real, it is common, and it can seriously affect a person’s quality of life. The data in this study support the theory that ADHD can affect work and marriage and that it is correlated with mental health as well.

It’s also not treated or even diagnosed in many cases, which suggests an opportunity to improve the way we screen for and treat adult ADHD.

This study was important in helping us understand how common ADHD is and how it impacts lives.

Study Quote
Kessler et al

Conclusions: 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.