WebMD Health News
Louise Chang, MD
May 27, 2008 -- Adults with attention deficit hyperactivity disorder (ADHD) work 22 fewer workdays than
their co-workers without the condition, according to a new study. The total
takes into account days absent and days of low productivity.
"When you compare these people to other people of the same age, sex, and
with the same education and see how they function [on the job], there is a
substantial amount of role impairment in ADHD," says Ron Kessler, PhD, a
co-author of the study and a professor of health care policy at Harvard Medical
The study was part of the World Mental Health Survey Initiative of the World
Health Organization (WHO). It is published online ahead of print in
Occupational and Environmental Medicine.
Kessler and his team screened more than 7,000 workers (including
self-employed workers) aged 18 to 44. The workers described their performance
on the job in the last month.
While ADHD is often thought of as a childhood problem, growing evidence
suggests that a substantial number of adults have the condition and that it is
underdiagnosed in adults. Those with ADHD find it difficult to concentrate due
to their distractibility, hyperactivity, impulsivity, or forgetfulness.
(What are your
thoughts about this study? Talk with others on WebMD's
Adults with ADD/ADHD message board.)
Though the WHO World Mental Health Surveys are conducted in 26 countries,
the recent study assessed only 10 countries for the prevalence of adult ADHD, Kessler says,
because these 10 were the only ones who "bothered to look at ADHD."
"What we discovered is a pretty substantial number of people have
ADHD," says Kessler.
Overall, "we had about 3.4% of people who had ADHD."
Country by country, France had the highest percentage of ADHD among adult
workers surveyed, followed by the U.S.; Spain had the lowest percentage.
The 10-country scorecard:
Overall, Kessler says, those with ADHD, compared with workers without the
condition, put in 22.1 fewer days a year -- nearly a month's worth of workdays.
About eight of those days were completely lost because they didn't work or
didn't carry out normal activities. The other 14 days had low productivity,
where the quantity or the quality of the work suffered, Kessler says.
"People with ADHD have more sick days and lower performance when they
work," Kessler tells WebMD. "This is one of those hidden illnesses in
The problem of ADHD in the workplace, until now, has not been investigated
much, says James T. McCracken, MD, vice chairman of the department of
psychiatry and biobehavioral sciences at the University of California Los
Angeles Semel Institute and Resnick Neuropsychiatric Hospital.
"Overall [the study] raises a really important issue," he says.
"It takes a look at an aspect of adult ADHD that until now has been not
that well quantified -- the work impact."
The numbers obtained by the researchers make sense, he says, from what he
has observed with patients.
"The finding that one month a year is lost is very significant from a
productivity standpoint," says Thomas Parry, PhD, president of the
Integrated Benefits Institute, a San Francisco-based nonprofit organization
that conducts research on workplace health and productivity.
Parry is working with Kessler to develop tools to better measure ADHD in the
Workers who have trouble concentrating and focusing, Kessler says, should
bring it up with their primary care doctor. "It's worth talking to your
doctor because you don't have to live like this."
McCracken agrees, noting that medication can help. Behavioral
therapy that addresses key problem areas such as poor organization have been
shown to help, too, he says.
The WHO Mental Health Survey Initiative is supported by the U.S. National
Institute of Mental Health, other public health organizations, pharmaceutical
companies, and other sources. The preparation of the current report was
partially supported by Eli Lilly and Co., which makes an ADHD drug, as well as
other survey initiative supporters. Lilly had no role in the study design,
results, or analysis.
SOURCES:Ron Kessler, PhD, professor of health care policy, Harvard Medical School,
Boston.De Graaf, R. Occupational and Environmental Medicine, published
online May 27, 2008.James T. McCracken, MD, vice chairman, department of psychiatry and
biobehavioral sciences, University of California Los Angeles Semel Institute
and Resnick Neuropsychiatric Hospital.Thomas Parry, PhD, president, Integrated Benefits Institute, San
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