Sociodemographics, Comorbidities, Healthcare Utilization and Work Productivity in Japanese Patients with Adult ADHD

Abstract

ObjectivesThis study compared the sociodemographic characteristics, comorbidities, healthcare resource utilization, and work productivity among Japanese adults who reported being diagnosed with attention-deficit/hyperactivity disorder (ADHD) to those of a non-ADHD control population.MethodsData for this study were captured from an online survey of adults in Japan conducted by Kantar Health using consumer panels. A total of 84 survey participants reported they had received a diagnosis of ADHD from a physician. Survey responses pertaining to functional status and resource utilization from this ADHD group were compared to those from a non-ADHD control group of 100 participants. Comparisons between the ADHD and non-ADHD groups were made using chi-square tests for categorical variables and t-tests for continuous variables.ResultsParticipants in the ADHD group were on average slightly younger with a higher proportion of males. ADHD respondents reported significantly more comorbid depression, sleep difficulties, headaches, and anxiety than non-ADHD controls. Over the previous 6 months, the ADHD group made more visits to healthcare providers and the emergency room, and had more hospitalizations than non-ADHD controls. The ADHD group also rated their overall health status lower than the non-ADHD control group. Respondents with ADHD reported a significantly higher degree of health-related work impairment compared to non-ADHD, with greater absenteeism and decreased work productivity. The ADHD group indicated their symptoms negatively impacted relationships, self-esteem, and regular daily activities.ConclusionsJapanese adults with ADHD face a substantial burden of illness, including lower overall health status, increased number of comorbidities, greater healthcare utilization, and significant health-related occupational impairment compared to those without ADHD. Additional research is needed to develop a better understanding of both the consequences and treatment approaches for Japanese adults with ADHD.

Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

“…Individuals with ADHD also experience neuropsychological difficulties associated with deficient inhibition [ 22 ], memory [ 22 ], executive functioning [ 23 , 24 ], decision making [ 25 ], and emotional dysregulation [ 26 ]. Adult ADHD can have negative consequences for individuals’ self-esteem and the quality of interpersonal relationships, with both colleagues and significant others [ 27 , 28 ]. For example, in a community sample of 1001 adults, those with ADHD were significantly more likely to have been divorced (28% vs 15% controls, P ≤ 0.001) and were significantly less satisfied with their personal, social and professional lives [ 29 ].…”

“…Adult ADHD has been associated with poorer driving and a higher incidence of traffic citations and motor vehicle accidents [ 35 ]. A recent study found that Japanese adults with ADHD visited physicians 10 times more often than a non-ADHD control group, and had rates of emergency room visits and hospitalization three times greater than controls [ 28 ]. Individuals with ADHD in Denmark have a lower life expectancy and more than double the risk of death than adults without ADHD [ 36 ].…”

Glyphosate Use Predicts Healthcare Utilization for ADHD in the Healthcare Cost and Utilization Project net (HCUPnet): A Two-Way Fixed-Effects Analysis

“…The ICD-9 codes that are included in the clinical classification software (CCS) diagnosis of attention-deficit, conduct, and disruptive behavior disorders are shown in Table S1 (data not shown) along with a translation to respective codes in the Diagnostic and Statistical Manual for Mental Disorders IV, Text Revision. Importantly, since children and adults with ADHD have significantly higher rates of healthcare utilization [35][36][37] (including hospitalizations), hospital discharge diagnoses may be an important discriminatory marker of ADHD in diverse populations, potentially screening out "pure" or less severe ADHD, which are said to be a minority of cases [37] and even "highly atypical" [38]. It was our goal to test whether herbicide use predicts healthcare utilization for ADHD (i.e., likely significant ADHD impairment).…”

“…We were not seeking to establish or utilize state-based prevalence of ADHD, as community prevalence rates employ differing methodologies and would, therefore, be unreliable [39]. To control for the central nervous system comorbidities that are often associated with an ADHD diagnosis [35][36][37], we have normalized the number of all-listed ADHD hospital discharges to a percentage of total discharges for all-listed mental disorders recorded in HCUPNET.…”

Re

“…2,3 Effective treatment of ADHD improves symptoms, emotional lability, and patient functioning. 4 While Paris et al's main concern is overtreatment of ADHD, we believe the risks of missed diagnosis and undertreatment, are far more compelling.…”