In a recent survey, more than half the college students with ADHD had at least 1 psychiatric disorder. The recent WHO World Mental Health Survey of college students assessed comorbidities in more than 15,000 college freshmen across 9 countries. The researchers who analyzed the results published their findings in the Journal of Attention Disorders.
A previous survey of United States college students with ADHD reported similar results, the researchers said. Despite the prevalence of comorbid psychiatric disorders, few of these students seek treatment or ask for accommodations.
The current survey was conducted among students in 24 colleges and universities across 9 countries (Australia, Belgium, Germany, Hong Kong, Mexico, Northern Ireland, South Africa, Spain, and the United States) between 2014 and 2018 using self-report questionnaires. The data report on prevalence of major depressive disorder (MDD), broad bipolar spectrum disorder (BPD), generalized anxiety disorder (GAD), panic disorder (PD), ADHD, and drug use disorder (DUD).
Of the 15,991 respondents who completed the survey, about 15.9% had ADHD for at least 6 months. About 29.4% of those had one or more mental health disorders for at least 1 year. Overall, more than half the respondents with ADHD had at least 1 other psychiatric disorder, and 30.7% had two comorbid disorders.
ADHD prevalence was higher in English speaking countries and lowest in Germany. ADHD was more common among individuals with higher parental education. Because the survey was based on self-report questionnaires, and also showed a higher rate of students with ADHD than previous studies, the researchers suspected ADHD is more common in college students than previously thought.
“Our analysis showed that ADHD and comorbid disorders all independently predicted impairment, suggesting these comorbid conditions to be separate entities,” they said. “In fact, the broad range of comorbid conditions associated with ADHD may reflect the vast overlaps of genetic profiles of ADHD with a large range of externalizing and internalizing disorders.”
Among the limitations, variable response rates may limit the representativeness of the reported cross-national prevalence of ADHD. The self-report format, which gives participants privacy, also introduces bias. The ADHD screen may also conflate with other disorders that have overlapping clinical features.
Nonetheless, considering the strong presence of ADHD and comorbid disorders among college freshmen, “multivariate disorder classes could be effectively deployed to allocate students with ADHD to services of different complexities and intensities,” the researchers suggest.
Mak ADP, Lee S, Sampson NA, et al. ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS). J Atten Disord. Published online November 10, 2021. doi:10.1177/10870547211057275