ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS)
Arthur D. P. Mak, Sue Lee, Nancy A. Sampson, Yesica Albor, Jordi Alonso, Randy P. Auerbach, Harald Baumeister, Corina Benjet, Ronny Bruffaerts, Pim Cuijpers, David Daniel Ebert, Raúl A. Gutiérrez–García, Penelope Hasking, Coral Lapsley, Christine Löchner, Ronald C. Kessler
Abstract
OBJECTIVE: To examine the prevalence of ADHD and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students. METHOD: About 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated a population attributable risk proportions (PARPs) of ADHD-related impairment. RESULTS: About 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%), and externalizing disorder classes (9.8%). ADHD, comorbidities, and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes. CONCLUSIONS: ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored.