We have long known about the negative impact of AD/HD in childhood on academic functioning, psychological health, and social adjustment. We are now learning more than ever about the possibility of destructive impact of AD/HD later in life and of discovering the benefits on the adult lives to early treatment of children with AD/HD.
Two recent studies from Norway have shed new light on the difficulties children with AD/HD face as they become adults. Dr. David Rabiner summarizes one of them in the recent edition of ADDA online. Over 400 adult men and women seeking treatment for AD/HD* were asked about their childhood and current functioning. As other studies have shown, adults with AD/HD, compared to a random sample of non-AD/HD controls, were less likely to have attained a college degree (23% vs. 59% of non-AD/HD controls in this study) and more likely to have less than a high school education (29% vs. 6% of controls), had higher lifetime rates of anxiety or depression (70% vs. 17% of controls), and more problems with alcohol (30% vs. 3 % of controls). The main and relatively novel focus of the study, though, was the striking finding that only 24% of the AD/HD patients were employed, compared to nearly 80% of the control group.
When the researchers looked at the impact of whether they had obtained treatment, including medication, as a child, the picture was much more encouraging. While less than 20% of the adult AD/HD patients had been treated with medication as a child, those now-adult patients (the ones who had been treated with medication) were three times more likely to have a job than the adults with AD/HD not given medication as a child.
Current and past medical treatment of AD/HD was positively correlated with having a job as an adult, and while a history of substance abuse, having the combined type of AD/HD (i.e., with hyperactivity) and a history of anxiety or depression made unemployment more likely, the good news is that reported treatment with stimulant medication as a child was the best single predictor of being employed as an adult. While taking medication as a child was also associated with less anxiety and depression as an adult, the authors concluded that “early recognition and treatment of AD/HD is a strong predictor of being in work as an adult, independent of comorbidity, substance abuse, and current treatment.”
A more recent study from Norway not yet in print (2) used a smaller sample of (149) adults and found a similar relationship between having AD/HD and unemployment. They also found in their medical records and responses to questionnaires that the younger they had experienced their first treatment with stimulant medication and the lower the severity of inattention the more likely that as adults they were employed.
Sure, Norway may be different from the United States, and we really cannot say that something as complex as future employment is a direct result of the impact of taking medication as a child. It may also be that the opportunity and motivation of families to seek treatment for their children might also be related to future employment prospects, but these studies do at least suggest the strong possibility that early treatment might make an important difference in the long run.
Doug Pentz, PhD
Affinity Center Co-director
(1)Halmoy, Fasmer, Gillberg and Haavik (2009).
“Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment; A Cross Sectional study of 414 Clinically Diagnosed Adult AD/HD Patients”. Journal of Attention Disorders, 13, 175-187].
(2) Gjervan, Torgersen, Nordahl and Kirsten Rasmussen, abstract available at: http://jad.sagepub.com/content/early/recent “Functional Impairment and Occupational Outcome in Adults with ADHD” Journal of Attention Disorders set for publication 2011
*Getting treatment apparently is very difficult for adults in Norway. This study used patients who were requesting treatment from their physicians. In Norway, they have to go through a long wait with an elaborate assessment procedure and then have their request for stimulant medication be approved by an “expert committee” which evaluates the merits of each request. And we thought it was difficult in the United States!