"With this large-scale study we were able to control for personal and family characteristics, including characteristics closely tied to ADHD status to arrive at our estimate of yearly household income losses due to the condition," said Dr. Biederman, a professor of psychiatry at Harvard Medical School and chief of clinical and research programs in pediatric psychopharmacology and adult ADHD at Massachusetts General Hospital in Boston, Mass. "Our study shows the problems faced by people with ADHD, associated with every aspect of life, ranging from school difficulties to emotional difficulties to problems in the workplace have enormous economic impact."
Eight million adult Americans are estimated to struggle with the inattention, impulsivity and hyperactivity of ADHD. Dr. Biederman spoke today at an American Medical Association media briefing on ADHD in New York City.
"Our survey shows that ADHD is a highly disabling disorder with a significant effect on a broad range of areas of functioning, including education and employment," Dr. Biederman said. "Even when matched for educational levels, ADHD individuals with a high school degree earn significantly less than their non-ADHD counterparts. On average, those with ADHD have household incomes that are about $10,791 lower for high school graduates and $4,334 lower for college graduates, compared to those who do not have ADHD."
"Adults with ADHD are less likely to have finished high school or to pursue further education," Dr. Biederman said. "Higher education was not only associated with an expected higher income, but was also associated with higher rates of full-time employment. We found that compared to high school education, those with a college degree were 20 percentage points more likely to have full-time employment. ADHD's effects on the ability to have full-time employment indirectly accounts for 17 percent of the projected $77 billion in losses due to ADHD."
"We saw that adults with ADHD had significant difficulties in the quality of their lives as well," he said. "They had higher divorce rates. Substance abuse was more common than in the control group. They reported a much lower level of satisfaction with all aspects of their lives. They were less likely to have a positive self-image or to be optimistic."
In the study, 500 adults who had been diagnosed with ADHD were matched for age and gender with 501 adults in the general population. In a 25-minute telephone interview, all the participants in the study were asked questions about school performance, substance abuse, driving records, use of tobacco, problems in the workplace, marital problems and problems with other relationships, their satisfaction with key aspects of their lives and their general outlook on life.
Participants in the study were evenly split between men and women. They were drawn from all over the country and included people from urban, suburban and rural areas. Of those with ADHD, about half had been diagnosed before they were 13 years old. More than one third (35 percent), however, had not been diagnosed until after age 18. Of those who had children, more than half reported that one or more of their children had also been diagnosed with ADHD. Only 36 percent of the adults with ADHD surveyed reported that they were taking a prescription medication for the disorder.
"These preliminary results underscore the importance of recognizing and understanding the problems faced by adults with ADHD," Dr. Biederman said. "It is striking that it appears that only about a third of those in the survey who have been diagnosed with ADHD are being treated appropriately. Better identification and treatment of adults with ADHD can improve lives and save Americans billions of dollars every year."
Media Advisory: To contact Joseph Biederman, M.D., contact Sue McGreevey at 617-724-2764 or at firstname.lastname@example.org. On the day of the briefing, call the AMA's Science News Department at 312-464-2410.