U.S. household income losses due to attention-deficit/hyperactivity disorder (ADHD) total nearly $77 billion each year, according to a new analysis of the national large-scale survey, "Capturing America's Attention," presented today at the American Psychiatric Association (APA) annual meeting in Atlanta.
"ADHD, a life-long disorder, may be one of the costliest medical conditions in the United States," said Joseph Biederman, M.D., Professor of Psychiatry, Harvard Medical School and Chief of Pediatric Psychopharmacology at Massachusetts General Hospital. "The same ADHD symptoms that may cause young patients to perform poorly in school or miss classes may also cause these patients, as adults, to lose a significant amount of income each year. The compelling results of this survey show that ADHD is a serious medical condition causing significant, life-long impairments. Evaluating, diagnosing and treating this condition may not only improve the quality of life, but may save adults with ADHD billions of dollars every year."
Biederman and his colleagues found that adults with ADHD have a lower educational attainment and achievement than healthy adults -- factors that not only significantly impact employment rates and income, but cause difficulties in the workplace as well. But even when the investigators accounted for educational attainment and achievement, they found the average loss of household income per adult with ADHD ranged from $8,900 to $15,400 per year, depending on the econometric model used.
Over eight million adult Americans, or 4.3 percent of working-age adults, struggle with the inattention, impulsivity and hyperactivity of ADHD. With this large-scale survey, researchers examined a weighted sample of 500 ADHD adults and 501 gender- and age-matched healthy adults that reflect the general U.S. population. They also accounted for personal and family characteristics, including characteristics closely tied to ADHD status, to arrive at the estimate of yearly household income losses due to the condition.
Nearly a quarter of the U.S. workforce (28 million workers ages 18 to 54) experience a mental disorder, according to a 2002 study by the University of Michigan. Employers are now starting to provide services that could be helpful to affected families including flexible work hours, family leave arrangements and childcare assistance, according to Dr. Biederman. Most employers offer employee assistance programs primarily targeted to helping employees deal with psychological issues, or work/life programs that focus on balancing work and family responsibilities.
ADHD affects educational attainment
According to the "Capturing America's Attention" survey results, adults with ADHD reported lower educational achievement and were less likely to be high school or college graduates. Higher education is associated with an expected higher income, and also is associated with higher rates of full-time employment. However, approximately 17 percent of the adults surveyed with ADHD did not graduate from high school, compared to 7 percent of those without ADHD. Similarly, just 19 percent of the adults with ADHD graduated from college compared to 25 percent of the adults without ADHD.
ADHD impacts employment
In the survey, adults with ADHD had more jobs during the last 10 years, averaging 5.4 jobs compared to adults without ADHD, who had 3.4 jobs. Of those surveyed, only 52 percent of the adults with ADHD were currently employed, compared to 72 percent of the adults surveyed without ADHD. Among adults with ADHD who were currently employed and had more than one job in the last 10 years, 43 percent reported that they lost or left one or more of those jobs in some part because of their ADHD symptoms.
ADHD causes "Lost Days"
ADHD adults in the survey were three times more likely to suffer from stress, depression or other problems with emotion. These emotional and physical effects can cause people with ADHD to "lose" days of their lives, Biederman explains. "Lost days" may manifest as a day absent from work or several times throughout the month when the person is not fully engaged both physically and emotionally. About one in four (24 percent) adults with ADHD said that on 11 days per month, on average, they were prevented from normal activities such as work, due to poor mental or physical health, compared to only nine percent of the adults without ADHD.
The "Capturing America's Attention" survey was conducted among more than 1,000 adults aged 18 and older by Roper Public Affairs (formerly Roper ASW) via telephone interviews. The sample list was comprised of households where it was indicated in a health profile survey that there was a member in residence, at least 18 years of age or more, who had been diagnosed with ADHD. Shire US Inc. supported this survey.