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Impact of Comorbidity in Adults With Attention-Deficit/Hyperactivity Disorder

Joseph Biederman, MD

Published: March 1, 2004

Article Abstract

Persistence of attention-deficit/hyperactivity disorder (ADHD) into adulthood and male-to-femaleratios of this disorder in childhood and adulthood have been controversial issues in the ADHD diagnosisin adults. Research has resolved these controversies and in turn provided support for the validity ofthe diagnosis in adults. Support for the diagnosis can also be found in data that show the lifetime prevalencerate for comorbid conditions such as antisocial disorders, mood and anxiety disorders, and substanceabuse disorders to be consistent across pediatric and adult populations with ADHD. These coexistingconditions add not only to the impairment associated with ADHD in adults but also to thedisorder’s economic burden, the extent of which is currently unknown. However, adults with the disorder,like children, probably have higher health care use and costs than people without the disorder.Little, too, is known about the social cost of ADHD, but if left untreated, the impact may be substantial.Research to determine the occupational costs associated with ADHD is ongoing, but until that andother cost-of-illness data are available, studies on the economic costs of the comorbid conditions depression,anxiety, and substance abuse and dependence may be used to make suppositions about theeconomic impact of ADHD in adults. More studies are needed on the outcomes of adults with thisdisorder, especially cost-of-illness studies.

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