The Prevalence and Effects of Adult Attention Deficit/Hyperactivity Disorder on Work Performance in a Nationally Representative Sample of Workers

TLDR

The study aims to determine the prevalence of adult ADHD and its workplace consequences, and to evaluate the need for effectiveness trials of screening and treatment programs. The authors used a national household survey of 3,198 adults aged 18–44, calibrated an ADHD screening tool against DSM‑IV diagnoses, and compared diagnoses with the WHO Health and Work Performance Questionnaire. They found that 4.2 % of workers had ADHD, which was associated with an average of 35 lost work days per year—especially 55.8 days for blue‑collar workers—amounting to 120 million lost days and $19.5 billion in annual human‑capital loss.

Abstract

Objective: The prevalence and workplace consequences of adult attention deficit/hyperactivity disorder (ADHD) are unknown. Methods: An ADHD screen was included in a national household survey (n = 3198, ages 18–44). Clinical reinterviews calibrated the screen to diagnoses of Diagnostic and Statistical Manual of Mental Disorders, 4th edition ADHD. Diagnoses among workers were compared with responses to the WHO Health and Work Performance Questionnaire (HPQ). Results: A total of 4.2% of workers had ADHD. ADHD was associated with 35.0 days of annual lost work performance, with higher associations among blue collar (55.8 days) than professional (12.2 days), technical (19.8 days), or service (32.6 days) workers. These associations represent 120 million days of annual lost work in the U.S. labor force, equivalent to $19.5 billion lost human capital. Conclusions: ADHD is a common and costly workplace condition. Effectiveness trials are needed to estimate the region of interest of workplace ADHD screening and treatment programs.