Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis
Open accessAbstract
Background: In spite of the growing literature about adult attention-deficit hyperactivity disorder (ADHD), relatively little is known about the prevalence and correlates of this disorder. Aims: To estimate the prevalence of adult ADHD and to identify its demographic correlates using meta-regression analysis. Method: We used the MEDLINE, PsycLit and EMBASE databases as well as hand-searching to find relevant publications. Results: The pooled prevalence of adult ADHD was 2.5% (95% CI 2.1–3.1). Gender and mean age, interacting with each other, were significantly related to prevalence of ADHD. Metaregression analysis indicated that the proportion of participants with ADHD decreased with age when men and women were equally represented in the sample. Conclusions: Prevalence of ADHD in adults declines with age in the general population. We think, however, that the unclear validity of DSM–IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD.
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It is unclear whether the prevalence of adult ADHD changes with age.
“it is unclear whether the prevalence of adult ADHD changes with age.”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [7]
The Results report a significant age-related decline in adult ADHD prevalence when men and women were equally represented, and the Conclusions state that prevalence declines with age in the general population. The paper says the cause of the observed decline is unclear, not whether its analysis found a change with age. The supplied passages have no page numbers. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredEG Willcutt estimated that the pooled prevalence of adult ADHD was 5.0% based on 11 studies published between 1996 and 2011 when defining adult ADHD with DSM-IV criteria.
“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 [15]
The Results and ‘Correlation of prevalence with gender and age’ sections report a pooled adult ADHD prevalence of 2.5% (95% CI 2.1–3.1) using strict DSM-IV criteria, not 5.0%. The paper does not attribute an 11-study estimate covering 1996–2011 to Willcutt. (LLM, conf=0.89)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredAdult ADHD prevalence is estimated at 2.5%.
“A meta-analysis of six studies with over 5,300 participants estimated the prevalence of ADHD in adulthood to be 2.5%”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Simon et al., 2009
The Results report a pooled adult ADHD prevalence of 2.5% (95% CI 2.1–3.1). The Abstract says six studies were omitted from 12 identified studies, consistent with six in the analysis, but the passages available from our copy do not substantiate the citing sentence’s figure of over 5,300 participants. (LLM, conf=0.83)
Experimental — accuracy not yet measuredCompared to childhood ADHD, adult ADHD has received far less research attention.
“compared to childhood ADHD, adult ADHD has received far less research attention”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [7]
The Abstract says ADHD was long thought to occur only in childhood and that, despite growing literature on adult ADHD, relatively little was known about its adult prevalence and correlates. That supports a research gap concerning adult ADHD, but the paper does not establish that adult ADHD received far less research attention than childhood ADHD overall. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAdult ADHD does rarely occur without other comorbid psychiatric symptoms and most adults with ADHD suffer from additional psychiatric disorders during their lifetime.
“Furthermore, adult ADHD does rarely occur without other comorbid psychiatric symptoms and most adults with ADHD suffer from additional psychiatric disorders during their lifetime (Simon et al. 2009; de Zwaan et al. 2012).”
From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Simon et al. 2009
The Abstract (page not specified in our copy) describes ADHD as a serious risk factor for comorbid psychiatric disorders. It does not say that ADHD rarely occurs without them or that most adults with ADHD have an additional psychiatric disorder during their lifetime. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Previous systematic reviews and meta-analyses of ADHD prevalence in children, adolescents and young adults have shown that prevalence estimates are highly heterogeneous mostly due to methodological differences of included studies.
“previous systematic reviews and metaanalyses of ADHD prevalence in children, adolescents and young adults (Polanczyk et al., 2007;Thomas et al., 2015;Simon et al., 2009;Polanczyk et al., 2014;Willcutt, 2012), have shown that prevalence estimates are highly heterogeneous mostly due to methodological differences of included studies.”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Simon et al., 2009
The Discussion says published estimates of adult ADHD prevalence vary greatly and attributes that variability to methodological and diagnostic differences between studies. This supports the claim’s explanation of heterogeneity, but the paper analyzes adult ADHD rather than prevalence across children, adolescents and young adults; its mention of a child-and-adolescent analysis does not extend its own conclusion to those groups. (LLM, conf=0.87)
Experimental — accuracy not yet measuredBased on pooled estimates from meta-analyses, ADHD affects 2.5% (95% CI 2.1-3.1) of adults worldwide.
“and 2.5 % (95 % CI = 2.1, 3.1) of adults across the world (Simon et al., 2009).”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Simon et al., 2009
The Results report a pooled adult ADHD prevalence of 2.5% (95% CI 2.1–3.1), matching the estimate. But the Study design section says the included convenience samples did not assure representativeness and their raw prevalence estimates could not be extended to the general population; the paper therefore does not establish this as a worldwide adult prevalence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThese estimates are lower than previously identified pooled prevalence estimates based on validated scales: 2.5% in adults with mean age 34 and 5.0% in young adults.
“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 Simon et al., 2009
The Results and Age sections report a pooled adult ADHD prevalence of 2.5% (95% CI 2.1–3.1) and a participant-weighted mean age of 34 years. The Correlation of prevalence with gender and age section says the estimate was based on strict DSM-IV diagnostic criteria, but does not establish that it was based on validated scales. The separately cited 5.0% estimate for young adults is not attributed to Simon et al. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSignificant 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.
“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 Simon et al., 2009
The Diagnosis results report statistically significant heterogeneity among the adult ADHD studies, and the Discussion attributes variation in published prevalence estimates to methodological and diagnostic differences. The paper also says demographic variables explain the heterogeneity at least in part; it does not establish that methodological differences account for most of it. This source analyzes adult, not child, ADHD prevalence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredStudies that require both a childhood-onset and adult symptoms report lower prevalence estimates than those that do not.
“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 [15]
The Conclusions passage (page not provided) says strict DSM-IV criteria may underestimate adult ADHD prevalence and that lowering the symptom threshold substantially affects prevalence estimates. It also describes a study that omitted the age-at-onset criterion, but that study changed other criteria too. The paper therefore does not establish the claimed comparison specifically between studies requiring both childhood onset and adult symptoms and studies that do not. (LLM, conf=0.78)
Experimental — accuracy not yet measuredV Simon and colleagues estimated that the pooled prevalence of adult ADHD was 2.5% based on six studies published between 1996 and 2005.
“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 [15]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe worldwide prevalence of ADHD in adults is approximately 2.5% (pooled prevalence 2.5%, 95% CI 2.1-3.1).
“Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide.”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [9]
Adult ADHD definitions strongly vary between studies.
“adult ADHD definitions strongly varying between studies”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [7]
The findings of Song et al. establish that the decrease in the population prevalence of ADHD that sets in during adolescence continues across adulthood.
“the findings of Song et al. establish that the decrease in the population prevalence of ADHD that sets in during adolescence continues across adulthood [7,8].”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [7]
Few large population-based data sets spanning the full adult lifespan are available.
“few large population-based data sets spanning the full adult lifespan available [4-7]”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [7]
The rate of adult ADHD is around 3%.
“The rate of adult ADHD is lower with around 3% (Fayyad et al. 2007; Kessler et al. 2006; Simon et al. 2009; Song et al. 2021).”
From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Simon et al. 2009
A limitation in studies of ADHD in older adults is the use of retrospective reporting of childhood symptoms and recall bias, with a potential underestimation of the prevalence.
“Another limitation in studies of ADHD in older adults is the use of retrospective reporting of childhood symptoms and recall bias, and a potential underestimation of the prevalence (Simon et al., 2009).”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Simon et al., 2009
Definitions of adult ADHD in epidemiological studies varied significantly.
“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 [15]
The prevalence of ADHD in the general adult population is 2.5% (95% CI 2.1-3.1).
“The general population prevalence of ADHD in adults has been estimated to be 2.5% (95% confidence interval [CI] 2.1-3.1)[14]”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [14]
The WMH surveys replicated the negative association between age and ADHD prevalence found in meta-analysis, despite the sample's truncated age range of 18-44.
“Meta-analysis finds that this association is negative (Simon et al. 2009), a result that we replicate in the WMH surveys despite the fact that the age range of our sample was truncated (18–44)”
From The descriptive epidemiology of DSM-IV adult ADHD in the world health organization world mental health surveys (2017) · cites this paper as Simon et al. 2009
Prevalence of ADHD in adults estimated from epidemiological studies is 2-5%.
“The prevalence of ADHD in adults estimated from epidemiological studies is in the range of 2-5% [16-19].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [16]
ADHD symptoms in some affected patients persist into adulthood, affecting approximately 2.5% of the adult population.
“Despite its declining prevalence with age, ADHD symptoms in some affected patients persist into adulthood, affecting ∼2.5% of the adult population (Simon et al., 2009).”
From A positron emission tomography study of nigro-striatal dopaminergic mechanisms underlying attention: implications for ADHD and its treatment (2013) · cites this paper as Simon et al., 2009
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P300 deficits in adults with attention deficit hyperactivity disorder: a meta-analysis
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- Authors
- Simon, V., Czobor, P., Bálint, S., Mészáros, Á., & Bitter, I.
- Affiliations
- Semmelweis University (HU)
- Corresponding author
- Simon, Viktória
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-03
- Volume
- 194
- Issue
- 3
- Pages
- 204-211
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2117104588
- Semantic Scholar
- 5b26e8f30b918f7a83a5c24dcc1dd769ad25fdcf
- Cited by
- 1,601
- References
- 69
- Citations by year
- 2026: 80 · 2025: 90 · 2024: 100 · 2023: 122 · 2022: 115 · 2021: 111 · 2020: 138 · 2019: 93 · 2018: 93 · 2017: 116 · 2016: 104 · 2015: 116 · 2014: 103 · 2013: 78 · 2012: 61
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, ADHD prevalence, demographic correlates, age differences, gender differences, DSM-IV diagnostic criteria, underestimation of prevalence, general population
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Regression Analysis, Sex Factors, Prevalence, Young Adult
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