ADHD-induced Lost Productivity Affects us All

People with ADHD who are out in the workforce perform 22.1 fewer days of work every year —a compilation of 8.4 days when they were unable to work or carry out their normal activities, 21.7 days of reduced work quantity, and 13.6 days of reduced work quality—than those without the disorder, according to study results published earlier this week at the online home of Occupational and Environmental Medicine. The results were obtained from 7,000 employed and self-employed workers age 18-44 years who were screened for ADHD and asked about their work performance in the previous month.

The missed days aren’t just affecting adults with ADHD and their employers; the loss of productivity affects all of us. Consider this:

• As of May 28, 2008 at 18:32 GMT the US population was 304,193,079.
• As of 2006, the latest date for which records are available, people under age 18 years accounted for 24.6% of the US population.
• ADHD afflicts approximately 3% to 5% of school-age children.
• The symptoms of ADHD continue into adulthood for about 60% of children with ADHD.

So, with these statistics, that’s 74,831,497 children in the US; 3,741,575 US children afflicted with ADHD; and 2,244,945 adults with ADHD symptoms. Multiply in the average 22.1 days of lost work for each adult with ADHD, and that’s 49,613,282 days—or 396,906,256 hours (based on an 8-hour work day)—of lost productivity per year in the US! In fact, the loss of productivity is so extensive that researchers are recommending that it would be more cost effective for employers to screen staff for ADHD and provide those who are diagnosed with the condition with the necessary treatment.

The Physician’s Role

The drastic effects ADHD can have on an adults patients’ quality of life underscore the need for early and accurate diagnosis and treatment of this condition, which means physicians need to stay up to date with the latest practice parameters, diagnosis guidelines, and guiding principles covering ADHD in adults.

The signs certainly point to a lack of awareness of adult ADHD among US physicians; the authors of a 2006 Harvard study stated that “adult ADHD symptoms often coexist with other mental and emotional disorders, such as depression or anxiety,” and “that because ADHD assessments have been traditionally targeted to children, ADHD is difficult to diagnose in adults.” They added that the symptoms tend to be more varied and subtler in adults than in children, suggesting that clinicians may need to consider a wider variety of possible symptoms for the condition to allow for better assessment in adults.”

Thus, a careful and comprehensive clinical evaluation of an adult patient suspected of having ADHD is key. To do so, the following tools may prove helpful:

• Copeland Symptom Checklist for Attention Deficit Disorders—Adult Version
• Brown ADD Rating Scales
• Wender-Reimherr Adult Attention Deficit Disorder Scale (available by contacting Fred W. Reimherr, MD, Mood Disorders Clinic, Department of Psychiatry, University of Utah Health Science Center, Salt Lake City, UT 84132)
• Wender Utah Rating Scale
• Adult Self-Report Scale
• Conner’s Adult ADHD Rating Scales
• Various evaluation forms from Russel A. Barkely, Phd, found in the “Attention-Deficit Hyperactivity Disorder: A Clinical Workbook”
• Stroop Color and Word Test
• Wechsler Adult Intelligence Scale and Wechsler Memory Scale, Third Edition