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Adult ADHD Costs Billions in Lost Income

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THURSDAY, Sept. 9 (HealthDayNews) -- While attention deficit-hyperactivity disorder (ADHD) is widely perceived as a children's disorder, many adults struggle with it, too.

It costs adult sufferers billions of dollars each year in lost wages and in the inability to hold steady jobs, making it one of the nation's more costly health problems -- more so than depression or alcohol or drug abuse.

Those startling statistics were presented Thursday at an American Medical Association press briefing on ADHD that was held in New York City.

An estimated 3 percent to 5 percent of U.S. adults have ADHD, but only 15 percent know they have the disorder, said Rafael Klorman, a professor of psychology and director of clinical training at the University of Rochester in New York and one of the briefing's speakers.

And 50 percent to 60 percent of children who have ADHD continue to exhibit the condition as adults, Klorman said.

There are some similarities in the behavior problems exhibited by adults and children with ADHD, Klorman said. "And there is a similarity in the effect of drug treatment and in executive brain dysfunction," he added.

"The typical pattern for adults with ADHD is trouble staying focused, trouble with time management, and trouble getting organized," said ADHD expert Dr. Edward Hallowell, director of the Hallowell Center in Sudbury, Mass. The most prevalent sign of adult ADHD is unexplained underachievement, he added.

Hallowell, who was not part of the AMA briefing, said the good news is that successful treatments are available. "It can change your life," he said.

In another presentation at the briefing, ADHD expert Dr. Joseph Biederman addressed the economic impact of adult ADHD on household income and full-time employment.

"It has been shocking to me when we calculated the economic impact of ADHD in adults," said 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.

Biederman's team compared income and employment records among 500 adults with ADHD to 500 adults without it.

They found that annual income was thousands of dollars lower among those with ADHD. Also, Biederman said, "Adults with ADHD are less likely to hold full-time employment than adults without ADHD." This was true regardless of race or sex, he added.

"Overall, people with ADHD have less annual income," Biederman said. "This was true for males and females. Those with ADHD had income approximately $10,791 lower per year among high school graduates, and about $4,334 lower for college graduates than their counterparts without ADHD."

The estimated yearly income loss for adults with ADHD in the United States is $77 billion, Biederman said. The numbers for drug abuse are $58 billion, for alcohol abuse $85 billion, and depression $43 billion, he said. "You can see that ADHD is one of the costliest medical conditions we have," he said.

Biederman believes that appropriate treatment could erase much of the disparity between those with and without ADHD. Primary treatments include stimulant medications such as Ritalin, he said.

Dr. David L. Katz, the director of the Prevention Research Center at Yale University's Schools of Public Health and Medicine, said, "Available data indicate we are concomitantly underdiagnosing and overdiagnosing ADHD, under- and over-treating it."

Katz, who also was not part of the AMA briefing, added, "We should neither be invoking ADHD to explain normal behavior in children, nor ignoring it when it is compromising the productivity and quality of life in an adult."

"Mental disorders and mental health should be accorded the same respect as their physical counterparts. The health of children and adults -- and, per Dr. Beiderman's assessment, the economy -- will all improve when we at last accept and respect that formula," Katz said.

More information

The National Institute of Mental Health has more about ADHD.

SOURCES: Joseph Biederman, M.D., professor of psychiatry, Harvard Medical School, and Chief, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston; Rafael Klorman, Ph.D., professor of psychology, director of Clinical Training, University of Rochester, New York; Edward Hallowell, M.D., director, Hallowell Center, Sudbury, Mass.; David L. Katz, M.D., M.P.H., director, Prevention Research Center Yale University Schools of Public Health and Medicine, New Haven, Conn.; Sept. 9, 2004, American Medical Association press conference on ADHD, New York City
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