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Men with ADHD as children fared worse socially, economically

Men who were diagnosed with attention-deficit/hyperactivity disorder as children had significantly worse educational, occupational, economic and social outcomes as adults compared with men who were not diagnosed with the disorder as children, according to recent data. Divorce, incarceration, mortality and ongoing psychiatric disorders were also more common in this population.

“Virtually all areas of adjustment have been found to be deficient in children with attention-deficit/hyperactivity disorder (ADHD), which has an estimated worldwide prevalence of 5%,” the researchers wrote. “Consequently, the long-term outcome of childhood ADHD is a major concern.”

Rachel G. Klein, PhD, of the Child Study Center at New York University Langone Medical Center, and colleagues performed a 33-year follow-up of the clinical and functional outcomes of white children aged 8 years who were diagnosed with ADHD. The study included 135 men with childhood ADHD and 136 men without the disorder. The researchers examined adulthood outcomes such as education, employment history, incarceration, divorce and prevalence of psychiatric disorders.

Results showed that men with childhood ADHD had 2.5 fewer years of education compared with those in the control group, and 31.1% did not complete high school vs. 4.4% of men without childhood ADHD. Few men with childhood ADHD (3.7%) were likely to have earned higher degrees compared with controls (29.4%). Although significantly fewer men with childhood ADHD were employed (P=.003), most of them held a job (83%). However, the median annual salary of men with childhood ADHD was $40,000 less than that of men without childhood ADHD, a “striking” economic disparity, according to the researchers.

More men with childhood ADHD were currently divorced (9.6% vs. 2.9%; P=.02), incarcerated (36.3% vs. 11.8%; P<.001) and were deceased (7.2% vs. 2.8%; P=.05).

Men with childhood ADHD also had higher rates of ongoing ADHD (22.2% vs. 5.1%; P<.001), antisocial personality disorder (16.3% vs. 0%; P<.001) and substance use disorders (14.1% vs. 5.1%; P=.01), but not mood (P=.36) or anxiety (P=.33) disorders.

The researchers noted several study limitations, including that women and other ethnic and social groups were excluded from the research.

Klein and colleagues wrote that the findings “stress the importance of continued monitoring and treatment of children with ADHD, even when conduct disorder is not evident.”

Disclosure: The researchers report no relevant financial disclosures.