ADHD may cause $77 billion in lost income

WASHINGTON, May 24 (UPI) -- Survey results released Monday suggest untreated attention-deficit hyperactivity disorder in adults may be one of the costliest medical conditions in the United States -- accounting for nearly $77 billion in lost income each year.

"The compelling results of this survey show that ADHD is a serious medical condition causing significant, life-long impairments," Dr. Joseph Biederman, professor of psychiatry at Harvard Medical School and an author on the study, said in a statement.

"Evaluating, diagnosing and treating this condition may not only improve the quality of life, but may save adults with ADHD billions of dollars every year," Biederman said.

The study was to be presented Monday at the American Psychiatric Association annual meeting in Atlanta. Shire, a pharmaceutical company that manufactures Adderall, a drug used to treat ADHD, supported the survey with an unrestricted grant.

Approximately 4 percent of working-age adults or 8 million people have ADHD. About half of children who suffer from the affliction still could have symptoms when they reach adulthood.

ADHD can be managed with medication, psychotherapy and behavioral modifications but the National Institute of Mental Health said, "Diagnosing an adult with ADHD is not easy."

Diagnosing the condition accurately involves a review of the patient's childhood behavior in conjunction with an interview with a parent, spouse or close friend.

The NIMH noted the disease often can manifest as other conditions in adults, including depression and anxiety. Adults with untreated ADHD also might have a history of problems at school and work and frequent automobile accidents.

In addition to Adderall, medications for ADHD include Ritalin, Concerta and Dexedrine. Straterra, manufactured by Eli Lilly, and Adderall XR are specifically approved for treating ADHD in adults, but the other drugs also are used for that purpose.

Lilly spokeswoman Jennifer Bunselmeyer told United Press International the most recent data available indicates 80 percent of adults with ADHD are undiagnosed.

Bunselmeyer said the company "is very committed to heightening awareness" about the disease among adults who might have it. These efforts include offering a screening test from the World Health Organization on the Lilly ADHD Web site, as well as a recently launched campaign of direct-to-consumer advertisements.

Robert Reynolds, a spokesman for the American Psychological Association and a psychologist in private practice in Middletown, Conn., told UPI a newer treatment option is something called EEG neurofeedback. This technique involves using video games and electrodes that monitor brain waves to teach the brain to better regulate and prevent ADHD tendencies.

Studies suggest EEG neurofeedback can have the same success rate as medication but without the side effects, said Reynolds, who runs a clinic for children and adult with ADHD.

"Many people really believe this is the way of the future," he added.

In the study, Biederman and colleagues compared 500 ADHD adults with 501 healthy adults that were matched for gender and age. The ADHD group generally attained lower levels of educational achievement, which can result in lowered income.

Seventeen percent of the ADHD group had not graduated from high school, compared to 7 percent of the healthy adults. The ADHD group also was less likely to obtain a college degree, with 19 percent graduating compared to 25 percent of the healthy group.

Interestingly, even after Biederman's team adjusted for the lower educational levels, the average loss of income among the ADHD group was $8,900 to $15,400 annually, suggesting the ADHD symptoms cause other factors that interfere with employment.

The employment history of the ADHD group was less stable than the healthy group. The ADHD sufferers had more jobs on average over the last 10 years and only 52 percent currently were employed, compared to 72 percent of the group without the condition.

Nearly half of the ADHD participants who were currently employed said they had lost or left at least one job in part due to their ADHD symptoms.

ADHD also had an effect on mental status, which could impair their ability to work. The ADHD adults were three times more likely to report stress and depression and 24 percent said they were unable to work 11 days per month due to mental or physical health problems.

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Steve Mitchell is UPI's Medical Correspondent. E-mail sciencemail@upi.com