Labour market marginalisation in young adults diagnosed with attention-deficit hyperactivity disorder (ADHD): a population-based longitudinal cohort study in Sweden

Abstract Background The objective of this population-based register study was (1) to investigate the association between young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and subsequent labour market marginalisation (LMM) in two comparison groups, i.e. matched young adults from the general population without ADHD and unaffected siblings to persons with ADHD and (2) to assess the role of comorbid disorders. Methods This study included all young adults in Sweden, aged 19–29 years, with an incident diagnosis of ADHD 2006–2011 (n = 9718). Crude and multivariate sex-stratified hazard ratios (HRs) with 95% confidence intervals (CIs) were measured 5 years after the diagnosis of ADHD for the risk of disability pension, long-term sickness absence (SA) (>90 days), long-term unemployment (>180 days) and a combined measure of all three in young adults with ADHD compared to their siblings without ADHD and a matched comparison group. Results In the adjusted analyses young adults with ADHD had a 10-fold higher risk of disability pension (HR = 10.2; CI 9.3–11.2), a nearly three-fold higher risk of long-term SA (HR = 2.7; CI 2.5–2.8) and a 70% higher risk of long-term unemployment (HR = 1.7; CI 1.6–1.8) compared to the matched comparison group. The risk estimates were lower compared to siblings for disability pension (HR = 9.0; CI 6.6–12.3) and long-term SA (HR = 2.5; CI 2.1–3.1) but higher in the long-term unemployed (HR = 1.9; CI 1.6–2.1). Comorbid disorders explained about one-third of the association between ADHD and disability pension, but less regarding SA and long-term unemployment. Conclusions Young adults with ADHD have a high risk for different measures of LMM and comorbidities explain only a small proportion of this relationship.

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Risk of suicide attempts in adolescents and young adults with attention-deficit hyperactivity disorder: a nationwide longitudinal study

The British Journal of Psychiatry ◽

10.1192/bjp.2018.8 ◽

2018 ◽

Vol 212 (4) ◽

pp. 234-238 ◽

Cited By ~ 17

Author(s):

Kai-Lin Huang ◽

Han-Ting Wei ◽

Ju-Wei Hsu ◽

Ya-Mei Bai ◽

Tung-Ping Su ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Young Adults ◽

Risk Factor ◽

Suicide Attempt ◽

Attention Deficit ◽

Suicide Attempts ◽

Population Based ◽

Hazard Ratio ◽

Adolescents And Young Adults ◽

Hyperactivity Disorder

BackgroundAttention-deficit hyperactivity disorder (ADHD) increases the risk of suicidal behaviours through psychiatric comorbidities; however, a significant direct association has not been observed between ADHD and suicide attempts.AimsTo evaluate the risk of suicide attempt in adolescents and young adults with ADHD.MethodUsing a nationwide, population-based insurance claims database, this longitudinal cohort study enrolled 20 574 adolescents and young adults with ADHD and 61 722 age- and gender-matched controls between 2001 and 2009. Any suicide attempt was identified from enrolment to 31 December 2011. The association between ADHD medications and the likelihood of suicide attempt was assessed.ResultsADHD was an independent risk factor for any suicide attempt (hazard ratio = 3.84, 95% CI = 3.19–4.62) and repeated suicide attempts (hazard ratio = 6.52, 95% CI = 4.46–9.53). Subgroup analyses of men, women, adolescents and young adults demonstrated the same trend. Methylphenidate or atomoxetine treatment did not increase the risk of suicide attempt or repeated suicide attempts. Long-term methylphenidate treatment was associated with a significantly decreased risk of repeated suicide attempts in men (hazard ratio = 0.46, 95% CI = 0.22–0.97).ConclusionADHD was a risk factor for suicide attempt and a stronger predictor of repeated suicide attempts, independent of comorbidities. Further investigation is warranted to explore the mechanism underlying the association between ADHD and suicidal behaviours.Declaration of interestNone.

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Association Between Smoking and Attention-Deficit/Hyperactivity Disorder Symptoms in a Population-Based Sample of Young Adults

Yearbook of Psychiatry and Applied Mental Health ◽

10.1016/s0084-3970(08)70512-7 ◽

2007 ◽

Vol 2007 ◽

pp. 214-215

Author(s):

J.C. Ballenger

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Young Adults ◽

Attention Deficit ◽

Population Based ◽

Hyperactivity Disorder

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Modifiers of Long-Term School Outcomes for Children with Attention-Deficit/Hyperactivity Disorder: Does Treatment with Stimulant Medication Make a Difference? Results from a Population-Based Study

Journal of Developmental & Behavioral Pediatrics ◽

10.1097/dbp.0b013e3180cabc28 ◽

2007 ◽

Vol 28 (4) ◽

pp. 274-287 ◽

Cited By ~ 88

Author(s):

William J. Barbaresi ◽

Slavica K. Katusic ◽

Robert C. Colligan ◽

Amy L. Weaver ◽

Steven J. Jacobsen

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Stimulant Medication ◽

Population Based ◽

School Outcomes ◽

Population Based Study ◽

Hyperactivity Disorder ◽

Outcomes For Children

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Clustering of social disadvantage with attention-deficit/hyperactivity disorder in young adults: a register-based study in Sweden

10.21203/rs.3.rs-140545/v1 ◽

2021 ◽

Author(s):

Marianna Virtanen ◽

Tea Lallukka ◽

Kristina Alexanderson ◽

Magnus Helgesson ◽

Katriina Heikkilä ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Young Adults ◽

Educational Attainment ◽

Young Adulthood ◽

Attention Deficit ◽

Disability Pension ◽

Social Disadvantage ◽

Hyperactivity Disorder ◽

Low Education

Abstract Background Whether clustering of social disadvantage in young adulthood is associated with attention-deficit/hyperactivity disorder (ADHD) is poorly understood. We examined clustering of ADHD with low educational attainment and unemployment in young adulthood; whether such clustering is stronger when unemployment was prolonged; and whether further clustering of disability pensioning, low education and unemployment occurs among those with ADHD. Methods Data were obtained from Swedish health, demographic and social security registers from which 8990 individuals with recorded ADHD diagnoses at the age of 10 to 35 and their 44387 matched references without mental disorders. Social disadvantage was measured using data on educational attainment, unemployment and disability pension from the diagnosis year or age 19 if diagnosed at younger age. Clustering was examined by comparing observed and expected occurrence (O/E ratio) of all possible combinations of ADHD, low education and unemployment, and, among those with ADHD, additional combinations with new-onset disability pension. Results The likelihood of having neither ADHD, low education nor unemployment was increased (O/E ratio = 1.20, 95% confidence interval 1.19–1.20 at baseline; 1.18, 1.17–1.18 at follow-up), as well as having all three characteristics (O/E ratio = 3.99, 3.89–4.10 at baseline; 5.68, 5.47–5.89 at follow-up). This clustering was stronger among women than men and when unemployment was prolonged. Among individuals with ADHD, clustering of low education with disability pension and unemployment was observed. Conclusions Low education and unemployment appear to cluster remarkably with ADHD among young adults, more so among women and when unemployment is prolonged.

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