Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study
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Data on incidence, prevalence and burden of ADHD are crucial for clinicians, patients, and stakeholders. We present the incidence, prevalence, and burden of ADHD globally and across countries from 1990 to 2019 from the Global Burden of Disease (GBD) study. We also: (1) calculated the ADHD prevalence based on data actually collected as opposed to the prevalence estimated by the GBD with data imputation for countries without prevalence data; (2) discussed the GBD estimated ADHD burden in the light of recent meta-analytic evidence on ADHD-related mortality. In 2019, GBD estimated global age-standardized incidence and prevalence of ADHD across the lifespan at 0.061% (95%UI = 0.040–0.087) and 1.13% (95%UI = 0.831–1.494), respectively. ADHD accounted for 0.8% of the global mental disorder DALYs, with mortality set at zero by the GBD. From 1990 to 2019 there was a decrease of −8.75% in the global age-standardized prevalence and of −4.77% in the global age-standardized incidence. The largest increase in incidence, prevalence, and burden from 1990 to 2019 was observed in the USA; the largest decrease occurred in Finland. Incidence, prevalence, and DALYs remained approximately 2.5 times higher in males than females from 1990 to 2019. Incidence peaked at age 5–9 years, and prevalence and DALYs at age 10–14 years. Our re-analysis of data prior to 2013 showed a prevalence in children/adolescents two-fold higher (5.41%, 95% CI: 4.67–6.15%) compared to the corresponding GBD estimated prevalence (2.68%, 1.83–3.72%), with no significant differences between low- and middle- and high-income countries. We also found meta-analytic evidence of significantly increased ADHD-related mortality due to unnatural causes. While it provides the most detailed evidence on temporal trends, as well as on geographic and sex variations in incidence, prevalence, and burden of ADHD, the GBD may have underestimated the ADHD prevalence and burden. Given the influence of the GBD on research and policies, methodological issues should be addressed in its future editions.
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“…methodological aspects of the GBD database [6 , 7 ], (ii) evidence that the GBD methodology might have led to inaccurate estimates in some analyses [6], (iii) the limited availability of nationwide cancer registry data in Germany only since 1999 [8 , 9], and (iv) according to the German Cancer…”
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“Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders, prevalent in around 4 – 6 % of children and adolescents worldwide (Cortese et al., 2023).”
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“Neuroscience is expected to help ‘stretch’ children and provide tools to improve their learning outcomes, not least by finding therapeutic solutions to increasing rates of ADHD diagnoses (Cortese et al., 2023).”
ADHD (over) diagnosis: fiction, fashion and failure
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“Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children characterized by inattentiveness, hyperactivity, and impulsivity (Posner, Polanczyk, & Sonuga-Barke, 2020), with a prevalence of ∼ 5% worldwide (Cortese et al., 2023).”
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“ADHD is a common psychiatric disorder that often continues into adulthood, posing a significant global health challenge [150].”
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“Worldwide prevalence is estimated to be around 5% [18–20].”
Self-citationPlant-based fat supply is associated with reduced ADHD disease burdenPreprint
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ADHD diagnoses are growing. What’s going on?
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“According to ADHD gender prevalence (Bonati et al. , 2021; Cortese et al. , 2023), 34 males and 2 females participated.”
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“Roughly 2—6% of children and adolescents receive a diagnosis of ADHD worldwide, making it among the most prevalent mental health conditions in young individuals [96].”
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“Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is estimated to affect between 3.5% and 11% of children [1–3].”
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“%) between 1990 and 2019 [2].”
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“ADHD is the most common neurodevelopmental condition with a prevalence of approximately 5% in school-age children 1 and is defined by symptoms of inattention and/or hyperactivity/impulsivity that are inconsistent with the developmental stage and substantially impair daily functioning 2 .”
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“The condition's impact has also contributed to a global burden of increase in disability-adjusted life years (DALYs) across 204 countries from 1990 to 2019 (Cortese et al., 2023).”
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“…(ADHD), characterized by developmentally inappropriate and impairing levels of inattention and/or hyperactivity impulsivity (American Psychiatric Association, 2022), affects at least 5% of school-aged children worldwide and is the most common neurodevelopmental disorder (Cortese et al., 2023).”
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- Authors
- Cortese, S., Song, M., Farhat, L. C., Yon, D. K., Lee, S. W., Kim, M. S., Park, S., Oh, J. W., Lee, S., Cheon, K.-A., Smith, L., Gosling, C. J., Polanczyk, G. V., Larsson, H., Rohde, L. A., Faraone, S. V., Koyanagi, A., Dragioti, E., Radua, J., Carvalho, A. F., Il Shin, J., & Solmi, M.
- Affiliations
- University of Nottingham (GB)
- Yonsei University (KR)
- Kyung Hee University Medical Center (KR)
- Samsung Medical Center (KR)
- Anglia Ruskin University (GB)
- Université Paris Cité (FR)
- Universidade de São Paulo (BR)
- Örebro University (SE)
- SUNY Upstate Medical University (US)
- Institució Catalana de Recerca i Estudis Avançats (ES)
- Linköping University (SE)
- Barwon Health (AU)
- University of Ottawa (CA)
- Corresponding author
- Cortese, Samuele
- ORCID
- Venue
- Molecular Psychiatry
- Published
- 2023-09-08
- Volume
- 28
- Issue
- 11
- Pages
- 4823-4830
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- OpenAlex
- W4386545385
- Semantic Scholar
- f8b56283bc7766f77ad4bb43cb4db49c94786551
- Cited by
- 211
- References
- 34
- Citations by year
- 2026: 68 · 2025: 91 · 2024: 47 · 2023: 4
- FWCI
- 37.16
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- INRIA a CCSD electronic archive server (submittedVersion)
- Figshare (submittedVersion, cc-by)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, incidence, prevalence, global burden of disease, disability-adjusted life years, sex differences, age distribution, temporal trends, children and adolescents, low- and middle-income countries, sex ratio bias, missing data imputation, unnatural causes of death
- MeSH terms
- Global Burden of Disease, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Humans, Male, Global Health, Incidence, Prevalence, Quality-Adjusted Life Years
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