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  • Posted March 18, 2021

Adult ADHD Can Mean Fewer Jobs, Worse Pay

A new study finds that attention deficit hyperactivity disorder (ADHD) continues to hamper people long after childhood ends. Researchers found that adults with ADHD often have a harder time holding their own in the workforce.

High school graduates with ADHD earn about 17% less than their peers without ADHD, are more likely to have stints of unemployment and to receive disability benefits because of their inability to work, according to a large study out of Sweden.

These differences are only partially explained by how far along these kids got in school.

Instead, "factors such as school performance, behavioral aspects [e.g., inattention/hyperactivity], and others are likely of continued importance for occupational outcomes as individuals diagnosed with ADHD enter the labor market," said study author Andreas Jangmo, of the Karolinska Institutet in Stockholm.

The research, published March 17 in the journal PLOS ONE, was funded by ADHD drugmaker Shire International GmbH.

Marked by trouble concentrating, sitting still and/or controlling impulsive behaviors, ADHD symptoms often continue into adulthood, according to the organization Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

To get a better idea of how kids with ADHD fare in the workforce as adults, Jangmo and colleagues followed 1.2 million Swedes for six to 16 years after high school graduation. Their information was then compared to a population-wide registry that tracks psychiatric diagnoses, medication use, education levels and job history.

ADHD tends to accompany other conditions such as speech and language disorders, which is why many people with ADHD in this study ended up on disability.

"Our study shows that this occupational gap between individuals with and without ADHD is persistent over time, and starts already in young adulthood," Jangmo said.

The study was not designed to say whether treating ADHD in childhood and beyond -- usually with a combo of medications, therapy and behavioral changes -- is enough to reverse any of these employment trends.

But U.S experts not involved in the research said they believe that effective treatment of ADHD in childhood will help these kids become more successful adults at home, in relationships and on the job.

"Problems in controlling attention and controlling behavior -- core problems in ADHD -- hinder the capacity to learn and apply skills," said Richard Gallagher, an associate professor of psychiatry at Hassenfeld Children's Hospital at NYU Langone in New York City.

People with ADHD enter the job market with less knowledge and fewer skills, he said.

"Once employed, the condition can interfere with job performance so it has an impact on advancement," Gallagher said.

But, he added, kids and teens who continue their treatment have better outcomes than those who do not or who interrupt treatment. "They show better school and work performance, have fewer legal difficulties, and use illicit substances at a lower rate," Gallagher said.

Dr. L. Eugene Arnold is a professor emeritus of psychiatry and behavioral health at Ohio State University College of Medicine. He agreed with Gallagher.

"If children go untreated, they are missing out on developmental opportunities, and this deficit will be a problem for them later on," Arnold said. "Later achievements may not be attained because of a lack of foundation, and that is how treatment in childhood could affect adult adjustment."

Although the study took place in Sweden, the results are likely similar in the United States and other countries, Arnold said.

More information

Learn more about ADHD and how it is treated at Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

SOURCES: Andreas Jangmo, PhD student, psychiatric epidemiology, Karolinska Institutet, Stockholm, Sweden; L. Eugene Arnold, MD, MEd, professor emeritus, psychiatry and behavioral health, Nisonger Center, Ohio State University, Columbus; Richard Gallagher, PhD, associate professor, child and adolescent psychiatry and psychiatry, Hassenfeld Children's Hospital, NYU Langone, New York City; PLOS ONE, March 17, 2021

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