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The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review
Open accessAbstract
This article describes a comprehensive meta-analysis that was conducted to estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). A systematic literature review identified 86 studies of children and adolescents (N = 163,688 individuals) and 11 studies of adults (N = 14,112 individuals) that met inclusion criteria for the meta-analysis, more than half of which were published after the only previous meta-analysis of the prevalence of ADHD was completed. Although prevalence estimates reported by individual studies varied widely, pooled results suggest that the prevalence of DSM-IV ADHD is similar, whether ADHD is defined by parent ratings, teacher ratings, or a best estimate diagnostic procedure in children and adolescents (5.9-7.1 %), or by self-report measures in young adults (5.0 %). Analyses of diagnostic subtypes indicated that the predominantly inattentive type is the most common subtype in the population, but individuals with the combined type are more likely to be referred for clinical services. Additional research is needed to determine the etiology of the higher prevalence of ADHD in males than females and to clarify whether the prevalence of ADHD varies as a function of socioeconomic status or ethnicity. Finally, there were no significant prevalent differences between countries or regions of the world after controlling for differences in the diagnostic algorithms used to define ADHD. These results provide important support for the diagnostic validity of ADHD, and argue against the hypothesis that ADHD is a cultural construct that is restricted to the United States or any other specific culture.
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“Only one study [76] documented the prevalence of ADHD in teenagers other than children, which is consistent with our findings.”
From The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis (2023) · cites this paper as [76]
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Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A meta-analysis of 19 studies with over 55,000 participants found that 5.9% of youths meet diagnostic criteria for ADHD”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Willcutt, 2012
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Parents have been shown to have better diagnostic determination for ADHD than teachers (despite bias and reliability issues), although utilizing a composite from multiple raters is better diagnostically than relying on one rater (O’Neill, Schneiderman, Rajendran, Marks, & Halperin, 2014; Willcutt, 2012).”
From Sensitivity and Specificity of an Executive Function Screener at Identifying Children with ADHD and Reading Disability (2021) · cites this paper as Willcutt, 2012
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Significant heterogeneity across studies has previously been identified in systematic reviews and meta-analyses of ADHD prevalence in children and adults, mostly due to methodological differences (Polanczyk et al., 2007;Simon et al., 2009;Willcutt, 2012).”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Willcutt, 2012
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“According to the findings of a 2012 study, the prevalence of ADHD in children aged 6 to 12 years was 11.4%, and in youngsters aged 12 to 18 years was 8%, which was slightly higher than our findings.”
From The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis (2023) · cites this paper as [76]
Experimental — accuracy not yet measured
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In the citing paper
“Given the fact that studies that require both a childhood-onset and adult symptoms (persistent adult ADHD) report lower prevalence estimates than those that do not (symptomatic adult ADHD), it is necessary to separately provide prevalence estimates for those two distinct groups.”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“As indicated in the previous two systematic reviews of adult ADHD, the definitions of adult ADHD in epidemiological studies varied significantly.”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“When defining adult ADHD with the DSM-IV criteria, EG Willcutt estimated that the pooled prevalence of adult ADHD was 5.0% based on 11 studies published between 1996 and 2011 [15,16].”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [16]
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“Impaired EFs are commonly observed in two prevalent neurodevelopmental disorders8: autism spectrum disorder (ASD, 1 in 68 children diagnosed with ASD9) and attention-deficit/hyperactivity disorder (ADHD, up to 1 in 15 children diagnosed with ADHD10).”
From Heterogeneity of executive functions among comorbid neurodevelopmental disorders (2016) · cites this paper as [10]
The cited source says what the claim attributes to it.
In the citing paper
“A meta-analysis of parent ratings of symptoms in 29 studies with over 42,000 participants, and teacher ratings in 24 studies with over 56,000 participants, found a roughly two-to-one male/female ratio in youth”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Willcutt, 2012
The cited source says what the claim attributes to it.
In the citing paper
“ADHD occurs throughout the developed and developing world and is more common in males compared with females.”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Willcutt, 2012
The cited source says what the claim attributes to it.
In the citing paper
“Notwithstanding the biological evidence suggesting a male majority in ASD similar to other developmental conditions such as ADHD (Willcutt 2012), there is still reason to suspect that females are missed or delayed in diagnosis more often than males.”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Willcutt 2012
The cited source says what the claim attributes to it.
In the citing paper
“This reflects the findings on the development of ADHD symptoms from childhood to adulthood, demonstrating that hyperactivity is more observable in children than in adults [14, 83, 84].”
From Assessing ADHD symptoms in children and adults: evaluating the role of objective measures (2018) · cites this paper as [14]
The cited source says what the claim attributes to it.
In the citing paper
“These estimates are lower than previously identified pooled prevalence estimates based on validated scales: 2.5 % (95 % CI = 2.1, 3.1) in adults with the mean age of 34, (Simon et al., 2009) and 5.0 % (95 % CI = 4.1, 6.2) in young adults (Willcutt, 2012).”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Willcutt, 2012
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In the citing paper
“Through a systematic review and meta-analysis of six studies published between 1996 and 2005, V Simon and colleagues estimated that the pooled prevalence of adult ADHD was 2.5%.”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [16]
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Citations
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“However, the gen der distribution in adulthood is more balanced, with inat tention being the most prevalent presentation (Hinshaw et al., 2022; Willcutt, 2012).”
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Metadata
- Authors
- Willcutt, E. G.
- Affiliations
- University of Colorado Boulder (US)
- Corresponding author
- Willcutt, Erik G.
- ORCID
- Willcutt, Erik G.
- Venue
- Neurotherapeutics
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 9
- Issue
- 3
- Pages
- 490-499
- ISSN
- 1878-7479 (ISSN-L)
- PMC
- PMC3441936
- OpenAlex
- W2102388069
- Semantic Scholar
- 3dc62515c876d6d3779838891645696284acfdaf
- Cited by
- 2,160
- References
- 35
- Citations by year
- 2026: 93 · 2025: 157 · 2024: 153 · 2023: 199 · 2022: 173 · 2021: 180 · 2020: 245 · 2019: 141 · 2018: 169 · 2017: 161 · 2016: 200 · 2015: 140 · 2014: 99 · 2013: 44 · 2012: 3
- FWCI
- 12.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neurotherapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (P50MH079485, P50MH79485, R01MH063207, R01MH63941, R01 MH62120, R01MH063941, R01MH062120, R01 MH 63207, R01MH070037)
- National Institute on Drug Abuse (R01 DA 24002, R01DA024002)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD068728, R01HD047264, P50-HD27802, R01 HD 68728, R01 HD 47264, R24HD075460, P50HD027802)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, ADHD prevalence, DSM-IV diagnostic criteria, children and adolescents, adults, predominantly inattentive type, combined type, sex differences, socioeconomic status, ethnicity, cross-cultural validity, diagnostic validity, parent and teacher ratings
- MeSH terms
- Algorithms, Attention Deficit Disorder with Hyperactivity, Humans, Prevalence, Databases, Factual, Diagnostic and Statistical Manual of Mental Disorders
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