Study: One in Six College Freshmen Has ADHD — Most with Comorbidities

November 22, 2021

Roughly 16 percent of college students worldwide have attention deficit hyperactivity disorder (ADHD or ADD), according to findings from an international survey spanning nine countries and dozens of colleges.

The study of ADHD in college students, published this month in the Journal of Attention Disorders¹, also found that 58 percent of students with ADHD have at least one comorbid disorder; 30 percent have two or more comorbid conditions.

Researchers derived the findings from a World Health Organization survey on college students and mental health (WMH-CIDI-SC). Roughly 16,000 college freshmen representing 24 colleges completed the online surveys between 2014 to 2018. The surveys comprised self-reported screening scales for ADHD and six other conditions — major depression, bipolar disorder, panic disorder, generalized anxiety disorder, drug use disorder, and alcohol use disorder.

ADHD prevalence rates did vary cross-nationally in the study, ranging from about 10 percent of total survey respondents in Germany to about 28 percent of total respondents in Australia. The authors also found that prevalence rates were lower in European sites and highest in English-speaking countries.

Total ADHD prevalence in this group, however, appears substantially higher than suggested by previously reported literature about college students, according to the authors. Prevalence of ADHD was also similar in both males (15.7 percent) and females (16.1 percent), which the authors attribute in part to improved symptom awareness in females.

The WHO study’s comorbidity rates are consistent with existing literature on college and community data. The authors divided survey data on the disorders into “profiles” for analysis, and found that:

• ADHD was present in about half of participants who also had internalizing disorders (depression, anxiety)
• About 60 percent of individuals with bipolar disorder also had ADHD
• About 76 percent of individuals with externalizing disorders (alcohol use disorder/drug use disorder) also had ADHD

One objective of the study was to examine the association between ADHD and impairment in college students. Findings show that ADHD, comorbidities, and the multivariate disorder classes (profiles) all independently predict severe impairment. What’s more, removing all ADHD cases, according to the authors, would hypothetically reduce severe impairment by about 20 percent in all college students.

Given the prevalence of ADHD in college students and the complexities that come with comorbid conditions, the authors note that a transdiagnostic approach should be explored to limit impairment and improve treatment.

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