The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys.
The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys.
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DOI：
10.1007/s12402-016-0208-3
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
WHO World Mental Health Survey Collaborators
中科院分区：
文献类型：
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作者：
Fayyad J;Sampson NA;Hwang I;Adamowski T;Aguilar-Gaxiola S;Al-Hamzawi A;Andrade LH;Borges G;de Girolamo G;Florescu S;Gureje O;Haro JM;Hu C;Karam EG;Lee S;Navarro-Mateu F;O'Neill S;Pennell BE;Piazza M;Posada-Villa J;Ten Have M;Torres Y;Xavier M;Zaslavsky AM;Kessler RC;WHO World Mental Health Survey Collaborators
我们之前报道了世界卫生组织世界心理健康 (WMH) 调查中前 10 个国家的 ADHD 跨国流行病学情况。当前的报告将之前的发现扩展到 20 项具有全国或地区代表性的 WMH 调查，这些调查现已收集了成人多动症的数据。在这些调查中，对高收入、中高收入和低收入/中低收入国家的 26,744 名受访者进行了综合国际诊断访谈 (CIDI)（平均答复率为 68.5%）。目前 DSM-IV/CIDI 各项调查中成人 ADHD 患病率平均为 2.8%，高收入国家 (3.6%) 和中高收入国家 (3.0%) 的患病率高于低收入/中低收入国家 (1.4%)。当前 ADHD 的条件患病率在儿童病例中平均为 57.0%，在儿童阈值以下病例中为 41.1%。成人多动症与男性、已婚和低教育程度显着相关。成人 ADHD 与 DSM-IV/CIDI 焦虑、情绪、行为和物质障碍高度共存，并且在控制共病时与角色障碍（脱离角色的天数、认知受损和社交互动）显着相关。所有国家的治疗寻求率都很低，并且主要针对合并症而不是多动症。这些结果表明，成人注意力缺陷多动障碍（ADHD）很普遍，具有严重的损害性和高度共病性，但在不同国家和文化中却未被充分认识和治疗。
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.