The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys

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

Ten-Year Trend and Correlates of Reported Posttraumatic Stress Disorder among Young Male Veteran Suicide Decedents-Results from the National Violent Death Reporting System, 16 U.S. States, 2005-2014

Objective:This study examined trends and correlates of reported post-traumaticstress disorder (PTSD) among young male Veteran suicide decedents, using datafrom the National Violent Death Reporting System from 2005–2014 on 1,362male U.S. Veteran suicide decedents aged 18–34 years.Methods:Prevalence of reported PTSD (i.e., diagnosis/symptoms) was determinedby mental health diagnostic fields and narratives and examined by year.Demographic, incident, and precipitating circumstance characteristics correlatedwith reported PTSD were identified.Results:One-hundred ninety-eight (15%) decedents had PTSD evidence. A 30-fold increase in reported PTSD prevalence occurred among decedents aged 25–34 years; however, no increase was observed among younger decedents. ReportedPTSD was associated with past deployments (odds ratio (OR): 14.5, 95%confidence interval (95% CI): 9.0–23.4); depression (OR: 1.8, 95% CI: 1.2–2.6);and divorce (OR: 1.7, 95% CI: 1.0–2.7). Recent crisis (OR: 0.6, 95% CI: 0.3–0.9)was inversely associated with reported PTSD.Conclusions:Reported PTSD prevalence substantially increased among Veteransuicide decedents aged 25–34 years suggesting it is beginning to play a larger rolein suicide for this group. Few correlated suicide risk factors were found, suggestingthat if symptoms of PTSD are present, heightened vigilance by providers forsuicide risk might be warranted, irrespective of evidence of other risk factors