The prevalence and correlates of adult ADHD

Ronald C. Kessler, Leonard A. Adler, Russell Barkley, Joseph Biederman, C. Keith Conners, Laurence L. Greenhill, Thomas Spencer

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

4 Scopus citations


It has long been known that attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders among children (Bird et al., 1988; Shekim et al., 1985). However, there is much less agreement about the extent to which ADHD persists into adulthood. Indeed, some authors state that adult ADHD is very rare (Shaffer, 1994), whereas others report that it is quite common (Barkley, 1997). The claim that adult ADHD is rare can be traced to theoretical discussions about the role of maturation in resolving childhood impulsivity (Cantwell, 1985). The empirical study that is consistently cited to support this claim is the influential meta-analysis carried out by Hill and Schoener (1996) of nine prospective studies of children who were diagnosed with ADHD and then followed between 4 and 16 years. The aim of the meta-analysis was to develop a mathematical model of the extent to which ADHD prevalence decreases with age. The nonlinear model developed by Hill and Schoener to fit the data in these nine studies estimated that ADHD prevalence decreases by approximately 50% every 5 years. Based on the assumption that ADHD prevalence is 4% in childhood, this model predicted that prevalence at age 40 would only be a fraction of 1%. Subsequent critiques have argued that several methodological factors (e.g. small number of studies, nonrepresentative studies, inappropriate statistical model, sample attrition, reporting bias) introduced imprecision and potential bias into the Hill and Schoener estimates of ADHD persistence (Mannuzza, Klein, & Moulton, 2003; Sawilowsky & Musial, 1988).

Original languageEnglish
Title of host publicationADHD in Adults
Subtitle of host publicationCharacterization, Diagnosis, and Treatment
PublisherCambridge University Press
Number of pages9
ISBN (Electronic)9780511780752
ISBN (Print)9780521864312
StatePublished - 1 Jan 2011
Externally publishedYes


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