Poul Jennum*, Anne Virring Sorensen, Lone Baandrup, Michael Ibsen, Rikke Ibsen and Jakob Kjellberg
Introduction: Research on the effects of treatment for Attention Deficit Hyperactivity Disorder (ADHD) on longterm educational and social outcomes are limited. We aimed to evaluate long-term outcomes in patients diagnosed with ADHD and the possible effects of early diagnosis in childhood (<18 years of age) compared with diagnosis in adulthood (18 years-30 years of age), as well as whether pharmacologic treatment for ADHD is associated with improved socioeconomic outcomes in adulthood.
Methods: We included patients diagnosed with ADHD and patients collecting ADHD medication in the period 1995-2016 using national registry data. Eligible patients were <30 years of age or had reached the age of 30 in the period 2005-2016 (minimum 10-year observation period). We applied a case-control design, matching patients with ADHD 1:4 with the general population based on age, sex, and municipality at index year.
Results: Patients with ADHD had poorer somatic and psychiatric health and lower social status at the age of 30 years compared with controls. An early diagnosis of ADHD (<18 years) had a positive effect on employment; a later diagnosis (18 years-30 years) was associated with increased psychiatric comorbidities, alcohol and drug abuse, and lower employment rates. We did not find an association between adherence to ADHD medication and having completed education at age 30. Adherence to ADHD medication appeared to have a negative effect on employment status at age 30, but this was confounded by psychiatric comorbidity severity.
Conclusions: Patients with ADHD experienced substantial socioeconomic difficulties impacting their daily lives, as demonstrated by increased direct health care costs, high rates of psychiatric comorbidities and co-medication use. We showed that stronger adherence to ADHD medication was associated with negative long-term effects on education and employment; however, psychiatric comorbidities were the main driver affecting the social outcomes.
Published Date: 2023-08-29; Received Date: 2023-08-01
