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Attention-deficit hyperactivity disorder (ADHD), or hyperkinetic disorder (HKD) can have a significant social impact on patients’ lives, causing disruption at school,1-4 work1,5-8 and in relationships.1,3,5,9,10 Symptoms of ADHD may also increase risk-taking behaviour.1,11,12

ADHD: improving visibility in adults

An overview of the societal impact of ADHD in adulthood, with consideration of opportunities to improve recognition and management

Evidence suggests that ADHD may reduce the quality of life of children, adolescents and adults.3,13-15 However, some positive aspects of ADHD have been reported.5,16 For example, a qualitative study of 8 individuals diagnosed with ADHD (21–50 years) reported improved functional abilities in areas including interpersonal skills, motivation, organisation and concentration span as a result of their ADHD.16

ADHD can be an economic burden, and is associated with increased healthcare costs for people of all ages with the disorder, possibly reflecting use of social care, education resources, treatment and productivity loss by family members due to ADHD-related activities.17-23 Adults with ADHD may also experience financial difficulties and have compulsive spending habits.5,10 ADHD can also be a financial burden to the families of patients.24,25

If left untreated, how can ADHD affect the lives of adults on a day-to-day basis? | Dr Joel Young | Rochester Centre for Behavioral Medicine, Rochester, MI, USA

  1. Biederman J, Faraone SV, Spencer TJ, et al. Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry 2006; 67: 524-540.
  2. Kuriyan AB, Pelham WE, Jr., Molina BS, et al. Young adult educational and vocational outcomes of children diagnosed with ADHD. J Abnorm Child Psychol 2013; 41: 27-41.
  3. Caci H, Doepfner M, Asherson P, et al. Daily life impairments associated with self-reported childhood/adolescent attention-deficit/hyperactivity disorder and experiences of diagnosis and treatment: results from the European Lifetime Impairment Survey. Eur Psychiatry 2014; 29: 316-323.
  4. Fredriksen M, Dahl AA, Martinsen EW, et al. Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD. Atten Defic Hyperact Disord 2014; 6: 87-99.
  5. Brod M, Pohlman B, Lasser R, et al. Comparison of the burden of illness for adults with ADHD across seven countries: a qualitative study. Health Qual Life Outcomes 2012; 10: 47.
  6. De Graaf R, Kessler RC, Fayyad J, et al. The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative. Occup Environ Med 2008; 65: 835-842.
  7. Shifrin JG, Proctor BE, Prevatt FF. Work performance differences between college students with and without ADHD. J Atten Disord 2010; 13: 489-496.
  8. Halmøy A, Fasmer OB, Gillberg C, et al. Occupational outcome in adult ADHD: impact of symptom profile, comorbid psychiatric problems, and treatment: a cross-sectional study of 414 clinically diagnosed adult ADHD patients. J Atten Disord 2009; 13: 175-187.
  9. Cussen A, Sciberras E, Ukoumunne OC, et al. Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr 2012; 171: 271-280.
  10. Pitts M, Mangle L, Asherson P. Impairments, diagnosis and treatments associated with attention-deficit/hyperactivity disorder (ADHD) in UK adults: results from the lifetime impairment survey. Arch Psychiatr Nurs 2015; 29: 56-63.
  11. Humphreys KL, Lee SS. Risk taking and sensitivity to punishment in children with ADHD, ODD, ADHD+ODD, and controls. J Psychopathol Behav Assess 2011; 33: 299-307.
  12. Sørensen L, Sonuga-Barke E, Eichele H, et al. Suboptimal decision making by children with ADHD in the face of risk: poor risk adjustment and delay aversion rather than general proneness to taking risks. Neuropsychology 2017; 31: 119-128.
  13. Caci H, Asherson P, Donfrancesco R, et al. Daily life impairments associated with childhood/adolescent attention-deficit/hyperactivity disorder as recalled by adults: results from the European Lifetime Impairment Survey. CNS Spectr 2015; 20: 112-121.
  14. Grenwald-Mayes G. Relationship between current quality of life and family of origin dynamics for college students with attention-deficit/hyperactivity disorder. J Atten Disord 2002; 5: 211-222.
  15. O’Callaghan P, Sharma D. Severity of symptoms and quality of life in medical students with ADHD. J Atten Disord 2014; 18: 654-658.
  16. Young S, Bramham J, Gray K, et al. The experience of receiving a diagnosis and treatment of ADHD in adulthood: a qualitative study of clinically referred patients using interpretative phenomenological analysis. J Atten Disord 2008; 11: 493-503.
  17. Telford C, Green C, Logan S, et al. Estimating the costs of ongoing care for adolescents with attention-deficit hyperactivity disorder. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 337-344.
  18. Braun S, Zeidler J, Linder R, et al. Treatment costs of attention deficit hyperactivity disorder in Germany. Eur J Health Econ 2012; 14: 939-945.
  19. Klora M, Zeidler J, Linder R, et al. Costs and treatment patterns of incident ADHD patients – a comparative analysis before and after the initial diagnosis. Health Econ Rev 2015; 5: 40.
  20. Le HH, Hodgkins P, Postma MJ, et al. Economic impact of childhood/adolescent ADHD in a European setting: the Netherlands as a reference case. Eur Child Adolesc Psychiatry 2014; 23: 587-598.
  21. Hodgkins P, Montejano L, Sasané R, et al. Cost of illness and comorbidities in adults diagnosed with attention-deficit/hyperactivity disorder: a retrospective analysis. Prim Care Companion CNS Disord 2011; 13.
  22. Hodgkins P, Montejano L, Sasané R, et al. Risk of injury associated with attention-deficit/hyperactivity disorder in adults enrolled in employer-sponsored health plans: a retrospective analysis. Prim Care Companion CNS Disord 2011; 13.
  23. Kawatkar AA, Knight TK, Moss RA, et al. Impact of mental health comorbidities on health care utilization and expenditure in a large US managed care adult population with ADHD. Value Health 2014; 17: 661-668.
  24. Hakkaart-van Roijen L, Zwirs BW, Bouwmans C, et al. Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 2007; 16: 316-326.
  25. Kleinman NL, Durkin M, Melkonian A, et al. Incremental employee health benefit costs, absence days, and turnover among employees with ADHD and among employees with children with ADHD. J Occup Environ Med 2009; 51: 1247-1255.
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