Authors: 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 D. Ebert; Raúl A. Gutierrez-Garcia; Penelope Hasking; Coral Lapsley; Christine Lochner; Ronald C. Kessler · Research

How Common is ADHD in College Students and How Does it Impact Their Lives?

A large international study finds ADHD is common among college students and often occurs alongside other mental health issues, leading to significant impairment in daily functioning.

Source: Mak, A. D. P., Lee, S., Sampson, N. A., Albor, Y., Alonso, J., Auerbach, R. P., Baumeister, H., Benjet, C., Bruffaerts, R., Cuijpers, P., Ebert, D. D., Gutierrez-Garcia, R. A., Hasking, P., Lapsley, C., Lochner, C., & Kessler, R. C. (2022). ADHD Comorbidity Structure and Impairment: Results of the WHO World Mental Health Surveys International College Student Project (WMH-ICS). Journal of Attention Disorders, 26(8), 1078-1096. https://doi.org/10.1177/10870547211057275

What you need to know

  • ADHD is much more common among college students than previously thought, affecting about 16% of students surveyed across 9 countries.
  • Over half of college students with ADHD also have other mental health conditions like depression or anxiety.
  • Having ADHD, with or without other mental health issues, significantly impairs students’ ability to function in daily life and academics.
  • Understanding the different patterns of ADHD and co-occurring conditions could help tailor more effective support services for students.

ADHD is surprisingly common in college students worldwide

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that involves ongoing patterns of inattention, hyperactivity, and impulsivity that interfere with functioning and development. While ADHD is often thought of as a childhood disorder, symptoms frequently persist into adulthood. This study examined how common ADHD is among college students around the world and how it impacts their lives.

The researchers surveyed nearly 16,000 college freshmen from 24 universities across 9 countries including Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, Hong Kong, and the United States. They found that about 16% of students screened positive for ADHD symptoms. This is substantially higher than previous estimates of ADHD prevalence in college students, which ranged from 2-11%.

There are a few possible reasons for this higher rate:

  1. Improved educational support may be helping more students with ADHD successfully enter college.
  2. The confidential, web-based survey used may have allowed students to more openly report symptoms.
  3. The demands of college may make ADHD symptoms more apparent compared to high school or work settings.

While rates varied somewhat between countries, ADHD was common across all sites surveyed. This suggests ADHD in college students is a global phenomenon that warrants attention from university health services worldwide.

ADHD often occurs alongside other mental health conditions

The study found that over half (58%) of students who screened positive for ADHD also had at least one other mental health condition in the past year. About 31% had two or more additional conditions.

The researchers used a statistical technique called latent class analysis to identify common patterns of co-occurring conditions among students with ADHD. They found four main groups:

  1. “Pure” ADHD (43%): These students only had ADHD symptoms without other conditions.
  2. Internalizing disorders (36%): In addition to ADHD, these students had conditions like depression or anxiety.
  3. Bipolar-related disorders (11%): This group had ADHD along with symptoms of bipolar disorder.
  4. Externalizing disorders (10%): These students had ADHD plus issues like substance use disorders.

Understanding these common patterns could help universities develop more targeted and effective support services for different subgroups of students with ADHD.

ADHD significantly impairs daily functioning

The study found that having ADHD symptoms, with or without other mental health conditions, was strongly associated with impairment in various areas of life. Students with ADHD were much more likely to report severe difficulties in:

  • Managing responsibilities at home
  • Maintaining close relationships
  • Social activities and interactions
  • Academic work and other responsibilities

Importantly, ADHD contributed to impairment independently from other mental health conditions. This means ADHD itself causes significant challenges for students, even if they don’t have depression, anxiety, or other issues.

The researchers estimated that if ADHD could be fully treated or prevented, it would reduce severe impairment among college students by about 19%. Even when accounting for other mental health conditions, addressing ADHD could still reduce impairment by about 10%.

Conclusions

  • ADHD is very common among college students worldwide, affecting about 1 in 6 students surveyed.
  • Most students with ADHD also have other mental health conditions, with depression and anxiety being most common.
  • Having ADHD significantly impairs students’ ability to function across multiple areas of life, including academics, relationships, and daily responsibilities.
  • Universities should consider implementing confidential ADHD screening for incoming students to identify those who may need support.
  • Treatment approaches that address both ADHD symptoms and co-occurring mental health issues may be most effective for many students.

This study highlights that ADHD is a major concern for college student mental health and academic success globally. Increased awareness, screening, and support services could substantially improve outcomes for the many students impacted by this condition. While further research is needed to confirm these findings, they suggest ADHD deserves more attention in college mental health initiatives worldwide.

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