The Effects of Attention-Deficit/Hyperactivity Disorder on Employment and Household Income

Joseph Biederman, MD; Stephen V. Faraone, PhD

Disclosures
In This Article

Introduction

Attention-deficit/hyperactivity disorder (ADHD) -- a condition characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsive behavior[1] -- was first believed to affect only children and adolescents but is now known to continue into adolescence and adulthood. ADHD occurs in approximately 2% to 18% of school-age children worldwide,[2,3] and up to 65% of affected children continue to be symptomatic into adulthood.[4,5,6,7] Current epidemiologic data estimate the prevalence of ADHD among adults at 5% in the US population,[8,9] which is consistent with follow-up studies of ADHD.[6]

ADHD has a profound impact on the way individuals participate in activities of daily living, with evidence suggesting a negative effect on behavior,[10] social skills,[11] interpersonal relationships,[12] educational achievement,[13] and work.[10] Adults with ADHD are at risk for antisocial behavior[14,15] and are likely to engage in a variety of harmful behaviors, such as drug abuse[10,15] and unlawful conduct.[10] They are also more likely than controls to have been diagnosed with a wide range of psychiatric conditions, including anxiety and mood disorders.[14,15]

Although increased healthcare costs for adults with ADHD were reported recently,[15] little is known about the cost to society in lost productivity. It can be deduced, however, that reduced educational achievement may limit employment options for adults with ADHD. In addition, individuals with ADHD miss significantly more days of work[15] and are more likely to be fired, change jobs, and have worse job performance evaluations than those without ADHD. These situations can adversely affect productivity,[16] but research to that end, as measured by income loss and cost to the US economy, has been limited.

In this survey, the impact of ADHD on individual employment and income was estimated, and the cost of ADHD on workforce productivity for the US population in 2003 was quantified. The primary hypothesis was that individuals with ADHD would have lower employment rates and, thus, lower incomes compared with controls, and that employed individuals with ADHD would have lower earnings than otherwise similar individuals without ADHD.

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