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The lifetime impact of attention deficit hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

Published online by Cambridge University Press:  16 August 2011

S. Bernardi ,
S. V. Faraone ,
S. Cortese ,
B. T. Kerridge ,
S. Pallanti ,
S. Wang  and
C. Blanco
S. Bernardi*
Affiliation:
Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
S. V. Faraone
Affiliation:
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
S. Cortese
Affiliation:
Institute for Pediatric Neuroscience, New York University Child Study Center, New York City, NY, USA
B. T. Kerridge
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
S. Pallanti
Affiliation:
Department of Psychiatry, University of Florence, Italy
S. Wang
Affiliation:
Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
C. Blanco
Affiliation:
Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA
*
*Address for correspondence: S. Bernardi, M.D., Department of Psychiatry, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 69, New York, NY, USA. (Email: [email protected])
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Abstract

Background

The aim of the study was to present nationally representative data on the lifetime independent association between attention deficit hyperactivity disorder (ADHD) and psychiatric co-morbidity, correlates, quality of life and treatment seeking in the USA.

Method

Data were derived from a large national sample of the US population. Face-to-face surveys of more than 34 000 adults aged 18 years and older residing in households were conducted during the 2004–2005 period. Diagnoses of ADHD, Axis I and II disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version.

Results

ADHD was associated independently of the effects of other psychiatric co-morbidity with increased risk of bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, specific phobia, and narcissistic, histrionic, borderline, antisocial and schizotypal personality disorders. A lifetime history of ADHD was also associated with increased risk of engaging in behaviors reflecting lack of planning and deficient inhibitory control, with high rates of adverse events, lower perceived health, social support and higher perceived stress. Fewer than half of individuals with ADHD had ever sought treatment, and about one-quarter had ever received medication. The average age of first treatment contact was 18.40 years.

Conclusions

ADHD is common and associated with a broad range of psychiatric disorders, impulsive behaviors, greater number of traumas, lower quality of life, perceived social support and social functioning, even after adjusting for additional co-morbidity. When treatment is sought, it is often in late adolescence or early adulthood, suggesting the need to improve diagnosis and treatment of ADHD.

Keywords

ADHDadultepidemiologyNESARCtreatment
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 875 - 887
Copyright
Copyright © Cambridge University Press 2011

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Supplementary material: File

Bernardi et al supplementary table

Table 1: Last twelve months psychiatric comorbidity of individuals with and without a lifetime diagnosis of ADHD in the National Epidemiologic Survey on Alcohol and Related Conditions

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