Behavioral Briefs: ADHD Has Repercussions Throughout Adulthood

Consequences of attention-deficit hyperactivity disorder (ADHD) are long-term, inhibiting adults with the disorder from reaching their full academic potential and limiting their sat isfaction with themselves and their relationships, a new survey shows. Results of "Capturing America's Attention" were presented at the American Psychiatric Association's annual meeting in May. This telephone survey of 1001 US adults, sponsored by Shire US Inc, is the first to examine the long-term impact of ADHD. The survey list was made up of households where it was indicated in a health profile survey that there was a resident aged 18 years or older with ADHD.

Survey findings showed that adults with ADHD are 3 times more likely to have a stress disorder, depression, or other emotional problems. Nearly a quarter of adults (24%) reported that they were unable to participate in normal activities (an average of 11 days a month) because of poor mental or physical health, compared with only 9% of adults without ADHD. Also, only 40% of adults with ADHD, versus 67% of adults without ADHD, "strongly agree" that their future is bright. Only half of the ADHD adults reported that they liked and accepted themselves for who they are, compared with 76% of the adults without ADHD.

More than 60% of the adults with ADHD surveyed have been addicted to tobacco, and 52% have used drugs recreationally. Persons with ADHD also were twice as likely to have been arrested than persons without ADHD—37% of ADHD adults acknowledged a prior arrest. In addition, persons with ADHD were twice as likely to be divorced or separated, and fewer than half of those surveyed who were currently in a relationship said they were "completely satisfied" with their significant other, compared with 58% of those without ADHD.

Of the ADHD adults, 17% did not graduate from high school and only 18% graduated from college, compared with 7% and 26%, respectively, of those without ADHD. Respondents with the disorder held an average of 5.4 jobs in a 10-year period. Those without held an average of 3.4 jobs. Of ADHD adults, 52% were currently employed at the time of the survey, compared with 72% of adults without ADHD. Of those currently employed who have had more than 1 job in the past 10 years, 43% reported that they left or lost 1 or more of those jobs in part because of their ADHD symptoms.

"The compelling results of this survey reinforce the fact that ADHD is a serious medical condition causing significant, life-long impairments," said Joseph Biederman, MD, professor of psychiatry, Harvard Medical School.

Women with a history of a major depressive episode were twice as likely as women with no history of depression to have metabolic syndrome, a collection of health risks that increase the likelihood of developing heart disease, stroke, and type 2 diabetes. Researchers at Stanford University School of Medicine found that this relationship remained even after controlling for age, race, education, smoking, physical inactivity, carbohydrate consumption, and alcohol use. Interestingly, men with a history of depression were not significantly more likely to have the metabolic syndrome, a finding the authors could not explain.

Data for this study, published in the May/June issue of Psychosomatic Medicine, were from the Third National Health and Nutrition Examination Survey. Participants were more than 6000 men and women aged 17 to 39 who did not have coronary heart disease or diabetes. These participants completed the depression module from the Diagnostic Interview Schedule and underwent a medical examination that provided clinical findings that were used to indicate the presence of metabolic syndrome.

Depressed women were particularly likely to have high blood pressure and high blood lipid levels. This may be because depressed persons are more likely to adopt unhealthy behaviors, such as smoking, eating unhealthy foods, being sedentary, and not complying with medical treatment, explained Leslie S. Kinder, PhD, the study's lead author.

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