ADHD

Prevalence and Impact Across the Lifespan

ADHD is a common mental health disorder that affects an estimated 3.6% of children and 2% of adults in the UK. Follow up studies of children with ADHD indicate that approximately 15% retain the full diagnosis at age 25, and a further 50% remain in partial remission  with persistance of some symptoms associated with significant impairments.¹

ADHD is typically a chronic condition which is often lifelong, and the impact and presentation can change over time frequently requiring lifelong monitoring and treatment.²

The chronicity of the disorder, and impact on function from childhood through to adulthood, is an important aspect of impairment with cumulative effects on self-esteem, mental wellbeing, and health-related quality of life.¹ Clinicians who follow individual patients, and their families should be knowledgeable about how ADHD presents, how it causes functional impairment across the lifespan, and ultimately how it  can be managed.²

Figure 1. Developmental Impact of ADHD Across the Lifespan. Adapted from CADDRA, 2018²

Pre-school children

Pre-school children with ADHD often display unusually poor  intensity of play and excessive motor restlessness. Associated difficulties, such as delayed development, oppositional behaviour,  and poor social skills, may also be present. Even at this early-stage parental stress may be huge when a child does not respond to  ordinary parental requests and behavioural advice.³

Primary school children

The primary school child with ADHD frequently begins to  be seen as being different as classmates start to develop  the skills and maturity that enable them to learn successfully  in school. Although a sensitive teacher may be able to adapt  the classroom to allow an able child with ADHD to succeed,  more frequently the child experiences academic failure,  rejection by peers, and low self-esteem.³

Adolescence

Adolescence may bring about a reduction in the overactivity  that is often so striking in younger children with ADHD,  but inattention, impulsiveness, and inner restlessness remain  major difficulties. A distorted sense of self and a disruption  of the normal development of self has been reported by  adolescents with ADHD. Furthermore, excessively aggressive,  and antisocial behaviour may develop, adding further problems.³

See figure 2

Adult

Adults who reported having received a diagnosis of ADHD were significantly less likely to have graduated from high school (83% vs. 93% of controls; p ≤ 0.001) or obtain a college degree (19% vs. 26%; p < 0.01), were less likely to be currently employed (52% vs. 72%; p ≤ 0.001) and had significantly more mean job changes over 10 years (5.4 vs. 3.4 jobs; p ≤ 0.001). They also were significantly more likely to have been arrested (37% vs. 18% of controls; p ≤ 0.001) or divorced (28% vs. 15%; p ≤ 0.001) and were significantly less satisfied (p ≤ 0.001) with their family, social and professional lives.⁴

Compared with non-sufferers, adults with ADHD are:

Less likely to GRADUATE from university
2x more likely to be ARRESTED
2x more likely to be DIVORCED
More likely to be UNEMPLOYED⁴

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Figure 2. Antisocial behaviour in adolescents with ADHD. Data primarily represents outcomes in those subjects with conduct disorders as teenagers. Adapted from Harpin, 2005³

ADHD - Continue Your Journey

References

UK Adult ADHD Network. Handbook for Attention Deficit Hyperactivity Disorder in Adults. 2013. Springer Healthcare Communications.
CADDRA – Canadian ADHD Practice Guidelines, 4th Edition. Canadian ADHD Resource Alliance (CADDRA), 2018
Harpin, VA., The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child 2005;90(SupplI):i2–i7.
Biederman, J. et al. Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. J Clin Psychiatry. 2006 Apr;67(4):524-40.doi: 10.4088/jcp.v67n0403