Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24% reported being in work, compared to 79% in a population-based control group (N = 359). Combined subtype of ADHD, substance abuse, and a reported history of depression or anxiety were correlated with being out of work. Current and past medical treatment of ADHD was correlated with being in work. Logistic regression analyses showed that stimulant therapy during childhood was the strongest predictor for being in work as adults (odds ratio = 3.2, p = .014). Conclusion: Early recognition and treatment of ADHD is a strong predictor of being in work as an adult, independently of comorbidity, substance abuse, and current treatment. (J. of Att. Dis. 2009; 13(2) 175-187)
Able, S.L., Johnston, J.A., Adler, L.A., & Swindle, R.W. ( 2007). Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychological Medicine, 37(1), 97-107.
2.
American Psychiatric Association. (1996). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
3.
Barkley, R. ( 2006). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York: Guilford.
4.
Barkley, R.A., Fischer, M., Edelbrock, C.S., & Smallish, L. ( 1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry , 29(4), 546-557.
5.
Barkley, R.A., Fischer, M., Smallish, L., & Fletcher, K. ( 2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder . Journal of Abnormal Psychology, 111(2), 279-289.
6.
Barkley, R.A., Fischer, M., Smallish, L., & Fletcher, K. ( 2003). Does the treatment of attention-deficit/hyperactivity disorder with stimulants contribute to drug use/abuse? A 13-year prospective study. Pediatrics, 111(1), 97-109.
7.
Barkley, R.A., Fischer, M., Smallish, L., & Fletcher, K. ( 2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry, 45(2), 192-202.
8.
Barkley, R., Murphy, K.R., & Fischer, M. ( 2007). ADHD in adults: What the science says. New York: Guilford.
9.
Bental, B., & Tirosh, E. ( 2007). The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder and reading disorder: A comparative study. Journal of Child Psychology and Psychiatry, 48(5), 455-463.
10.
Biederman, J., Faraone, S.V., Spencer, T.J., Mick, E., Monuteaux, M.C., & Aleardi, M. ( 2006). Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. Journal of Clinical Psychiatry, 67(4), 524-540.
11.
Biederman, J., Faraone, S.V., Spencer, T., Wilens, T., Norman, D., Lapey, K.A., et al. (1993). Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. American Journal of Psychiatry, 150(12), 1792-1798.
12.
Biederman, J., Mick, E., & Faraone, S.V. ( 2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. American Journal of Psychiatry, 157(5), 816-818.
13.
DelBello, M.P., Soutullo, C.A., Hendricks, W., Niemeier, R.T., McElroy, S.L., & Strakowski, S.M. (2001). Prior stimulant treatment in adolescents with bipolar disorder: Association with age at onset. Bipolar Disorders, 3(2), 53-57.
14.
Faraone, S.V., Biederman, J., Mennin, D., Wozniak, J., & Spencer, T. ( 1997). Attention-deficit hyperactivity disorder with bipolar disorder: a familial subtype?Journal of the American Academy of Child and Adolescent Psychiatry, 36(10), 1378-1387; discussion 1387-1390.
15.
Faraone, S.V., Biederman, J., Wilens, T.E., & Adamson, J. ( 2007). A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults. Psychological Medicine, 37(12), 1743-1752.
16.
Faraone, S.V., Sergeant, J., Gillberg, C., & Biederman, J. ( 2003). The worldwide prevalence of ADHD: is it an American condition?World Psychiatry, 2(2), 104-113.
17.
Fayyad, J., De Graaf, R., Kessler, R., Alonso, J., Angermeyer, M., Demyttenaere, K., et al. (2007). Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. British Journal of Psychiatry, 190, 402-409.
18.
Fischer, M., Barkley, R.A., Smallish, L., & Fletcher, K. ( 2002). Young adult follow-up of hyperactive children: Self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD. Journal of Abnormal Child Psychology , 30(5), 463-475.
19.
Fossati, A., Di Ceglie, A., Acquarini, E., Donati, D., Donini, M., Novella, L., et al. (2001). The retrospective assessment of childhood attention deficit hyperactivity disorder in adults: Reliability and validity of the Italian version of the Wender Utah Rating Scale. Comprehensive Psychiatry, 42(4), 326-336.
20.
Grevet, E.H., Bau, C.H., Salgado, C.A., Fischer, A.G., Kalil, K., Victor, M.M., et al. (2006). Lack of gender effects on subtype outcomes in adults with attention-deficit/hyperactivity disorder: Support for the validity of subtypes. European Archives of Psychiatry and Clinical Neuroscience, 256(5), 311-319.
21.
Halleland, H., Lundervold, A., Halmøy, A., Johansson, S., Haavik, J. ( 2008). Association between Catechol O-methyltransferase (COMT) haplotypes and severity of hyperactivity symptoms in adults. American Journal of Medial Genetics Part B: Neuropsychiatric Genetics . (Epub ahead of print)
22.
Hechtman, L., & Greenfield, B. (2003). Long-term use of stimulants in children with attention deficit hyperactivity disorder: Safety, efficacy, and long-term outcome. Paediatric Drugs, 5(12), 787-794.
23.
Heiervang, E., Stormark, K.M., Lundervold, A.J., Heimann, M., Goodman, R., Posserud, M.B., et al. (2007). Psychiatric disorders in Norwegian 8- to 10-year-olds: An epidemiological survey of prevalence, risk factors, and service use. Journal of the American Academy of Child and Adolescent Psychiatry, 46(4), 438-447.
24.
Hirschfeld, R.M., Cass, A.R., Holt, D.C., & Carlson, C.A. ( 2005). Screening for bipolar disorder in patients treated for depression in a family medicine clinic. Journal of the American Board of Family Practice, 18(4), 233-239.
25.
Hirschfeld, R.M., Holzer, C., Calabrese, J.R., Weissman, M., Reed, M., Davies, M., et al. (2003). Validity of the Mood Disorder Questionnaire: A general population study. American Journal of Psychiatry , 160(1), 178-180.
26.
Hirschfeld, R.M., Williams, J.B., Spitzer, R.L., Calabrese, J.R., Flynn, L., Keck, P.E., Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire . American Journal of Psychiatry, 157(11), 1873-1875.
27.
Jacob, C.P., Romanos, J., Dempfle, A., Heine, M., Windemuth-Kieselbach, C., Kruse, A., et al. (2007). Co-morbidity of adult attention-deficit/ hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. European Archives of Psychiatry and Clinical Neuroscience, 257(6), 309-317.
28.
Johansson, S., Halleland, H., Halmøy, A., Jacobsen, K., Landaas, E., Dramsdahl, M., et al. (2008). Genetic analyses of dopamine related genes in adult ADHD patients suggest an association with the DRD5-microsatellite repeat, but not with DRD4 or Dat1 VNTRs. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics.Dec 5;147B(8):1470-5.
29.
Kessler, R.C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., et al. (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population . Psychological Medicine, 35(2), 245-256.
30.
Kessler, R.C., Adler, L., Barkley, R., Biederman, J., Conners, C.K., Demler, O., et al. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication . American Journal of Psychiatry, 163(4), 716-723.
31.
Kessler, R.C., Adler, L.A., Barkley, R., Biederman, J., Conners, C.K., Faraone, S.V., et al. (2005). Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: Results from the national comorbidity survey replication. Biological Psychiatry, 57(11), 1442-1451.
32.
Lambert, N.M. ( 1988). Adolescent outcomes for hyperactive children. Perspectives on general and specific patterns of childhood risk for adolescent educational, social, and mental health problems. American Psychologist , 43(10), 786-799.
33.
Lambert, N.M., & Hartsough, C.S. (1998). Prospective study of tobacco smoking and substance dependencies among samples of ADHD and non-ADHD participants . Journal of Learning Disabilities, 31(6), 533-544.
34.
Mannuzza, S., Klein, R.G., Bessler, A., Malloy, P., & LaPadula, M. ( 1993). Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Archives of General Psychiatry, 50(7), 565-576.
35.
Murphy, K.R., Barkley, R.A., & Bush, T. ( 2002). Young adults with attention deficit hyperactivity disorder: Subtype differences in comorbidity, educational, and clinical history . Journal of Nervous and Mental Disease, 190(3), 147-157.
36.
Newcorn, J.H., Miller, S.R., Ivanova, I., Schulz, K.P., Kalmar, J., Marks, D.J., et al. (2004). Adolescent outcome of ADHD: Impact of childhood conduct and anxiety disorders. CNS Spectrums, 9(9), 668-678.
37.
Oncu, B., Olmez, S., & Senturk, V. ( 2005). Validity and reliability of the Turkish version of the Wender Utah Rating Scale for attention-deficit/hyperactivity disorder in adults [Article in Turkish. Abstract in English]. Türk Psikiyatri Dergisi, 16(4), 252-259.
38.
Pliszka, S.R. ( 1998). Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: An overview. Journal of Clinical Psychiatry, 59(Suppl. 7), 50-58.
39.
Rasmussen, K., Almvik, R., & Levander, S. ( 2001). Attention deficit hyperactivity disorder, reading disability, and personality disorders in a prison population. Journal of the American Academy of Psychiatry and the Law, 29(2), 186-193.
40.
Rasmussen, K., & Levander, S. ( 2008). Untreated ADHD in Adults: Are there sex differences in symptoms, comorbidity, and impairment?Journal of Attention Disorders. Epub ahead of print March 26, 2008. DOI: 10.1177/1087054708314621.
41.
Rasmussen, P., & Gillberg, C. ( 2000). Natural outcome of ADHD with developmental coordination disorder at age 22 years: A controlled, longitudinal, community-based study . Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), 1424-1431.
42.
Reichart, C.G., & Nolen, W.A. ( 2004). Earlier onset of bipolar disorder in children by antidepressants or stimulants? An hypothesis. Journal of Affective Disorders , 78(1), 81-84.
43.
Rodriguez-Jimenez, R., Ponce, G., Monasor, R., Jimenez-Gimenez, M., Perez-Rojo, J.A., Rubio, G., et al. (2001). Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention deficit/hyperactivity disorder in childhood. [Article in Portuguese. Abstract in English]. Revista de Neurologia, 33(2), 138-144.
44.
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl. 20), 22-33; quiz 34-57.
45.
Sobanski, E., Bruggemann, D., Alm, B., Kern, S., Deschner, M., Schubert, T., et al. (2007). Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). European Archives of Psychiatry and Clinical Neuroscience, 257(7), 371-377.
46.
Sprafkin, J., Gadow, K.D., Weiss, M.D., Schneider, J., & Nolan, E.E. ( 2007). Psychiatric comorbidity in ADHD symptom subtypes in clinic and community adults. Journal of Attention Disorders , 11(2), 114-124.
47.
Statistics Norway. (2005). Labour Market. Retrieved January 2008 from http://ssb.no/emner/06/arbeid/
48.
Torgersen, T., Gjervan, B., & Rasmussen, K. ( 2006). ADHD in adults: A study of clinical characteristics, impairment and comorbidity. Nordic Journal of Psychiatry, 60(1), 38-43.
49.
Vitiello, B. ( 2001). Long-term effects of stimulant medications on the brain: Possible relevance to the treatment of attention deficit hyperactivity disorder . Journal of Child and Adolescent Psychopharmacology , 11(1), 25-34.
50.
Ward, M.F., Wender, P.H., & Reimherr, F.W. (1993). The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. American Journal of Psychiatry, 150(6), 885-890.
51.
Weiss, G., & Hechtman, L. ( 1993). Hyperactive children grown up: ADHD in children, adolescents, and adults (2nd ed.). New York : Guilford.
52.
Wilens, T.E., & Dodson, W. ( 2004). A clinical perspective of attention-deficit/hyperactivity disorder into adulthood. Journal of Clinical Psychiatry, 65(10), 1301-1313.
53.
Wilens, T.E., Faraone, S.V., Biederman, J., & Gunawardene, S. (2003). Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics, 111(1), 179-185.
