Burden of illness and health care resource utilization in adult psychiatric outpatients with attention-deficit/hyperactivity disorder in Europe
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OBJECTIVE: To assess the burden of illness and health care resource utilization of adult nonpsychotic psychiatric outpatients with attention-deficit/hyperactivity disorder (ADHD) in Europe. METHODS: This was a multicountry, cross-sectional, observational study where unselected routine patients from clinical psychiatric outpatient settings were screened and assessed for ADHD. Patients were evaluated using the Clinical Global Impressions of Severity (CGI-S) scale, the Sheehan Disability Scale (SDS), and the EuroQol-5 Dimensions questionnaire. Data on comorbidities, functional impairment, and health care resource utilization were captured. RESULTS: The study enrolled 2284 patients, of whom 1986 completed the study. The prevalence of ADHD was 17.4%, of whom 46.0% had a previous ADHD diagnosis. Patients with ADHD had a high clinical burden with psychiatric comorbidities, especially depression (43.0%) and anxiety disorders (36.4%). Substance abuse (9.2% vs. 3.4%) and alcohol abuse (10.3% vs. 5.2%) were more common in the ADHD cohort vs. the non-ADHD cohort. Only 11.5% of the patients with ADHD had no other psychiatric disorder. Various measures indicated a significantly poorer level of functioning for patients with ADHD than without ADHD, as indicated by higher scores for CGI-S (3.8 vs. 3.3) and SDS (18.9 vs. 11.6) and higher percentages of debt (35.5% vs. 24.3%) and criminality (13.8% vs. 6.1%). Lastly, the health care resource utilization was considerable and similar between adult psychiatric outpatients diagnosed and not diagnosed with ADHD. CONCLUSIONS: Although care was taken when choosing the sites for this study, to make it representative of the general outpatient adult psychiatric population, caution should be advised in generalizing the findings of our study to the general ADHD or psychiatric outpatient population. This was an observational study, thus no inference on causality can be drawn. Having ADHD imposes a considerable health and social burden on patient and health care resource utilization comparable to other chronic psychiatric disorders.
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Prior studies have demonstrated the clinical and economic burden borne by adult patients with ADHD compared with their counterparts without ADHD, but few studies have evaluated the incremental burden imposed by common ADHD psychiatric comorbidities.
“The burden of ADHD has been demonstrated in prior studies evaluating the clinical and economic burden borne by adult patients with ADHD compared with their counterparts without ADHD,3-5,14,15 but few studies have evaluated the incremental burden imposed by common ADHD psychiatric comorbidities.”
From Health care resource utilization and costs associated with psychiatric comorbidities in adult patients with attention-deficit/ hyperactivity disorder (2024) · cites this paper as [14]
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Experimental — accuracy not yet measuredThe WMH finding of high comorbidity in ADHD is consistent with much previous research.
“Our finding of high comorbidity in ADHD is consistent with much previous research”
From The descriptive epidemiology of DSM-IV adult ADHD in the world health organization world mental health surveys (2017) · cites this paper as Karlsdotter et al. 2016
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Collaborators, O. B. O. T. W. W. M. H. S., Fayyad, J., Sampson, N. A., Hwang, I., Adamowski, T., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H. S. G., Borges, G., de Girolamo, G., et al. (2017) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-016-0208-3 · Cited by 824 · see citing works
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- Authors
- Karlsdotter, K., Bushe, C., Hakkaart, L., Sobanski, E., Kan, C. C., Lebrec, J., Kraemer, S., Dieteren, N. A. H. M., & Deberdt, W.
- Affiliations
- Lilly UK, Windlesham, Surrey, United Kingdom;
- Erasmus University Rotterdam (NL)
- Heidelberg University (DE)
- Radboud University Medical Center (NL)
- Lilly Deutschland GmbH, Bad Homburg, Germany;
- Eli Lilly (Germany) (DE)
- Lilly Nederland BV, Houten, the Netherlands;
- Eli Lilly Benelux, Brussels, Belgium
- Corresponding author
- Karlsdotter, Kristina
- ORCID
- Sobanski, Esther
- Venue
- Current Medical Research and Opinion
- Publisher
- Informa UK Limited
- Published
- 2016-06-16
- Volume
- 32
- Issue
- 9
- Pages
- 1547-1556
- ISSN
- 0300-7995 (ISSN-L)
- 1473-4877
- OpenAlex
- W2387032369
- Cited by
- 30
- References
- 7
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 4 · 2022: 5 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 2 · 2016: 1
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- green
- pure.eur.nl
- Licence
- other-oa
- Locations
- Current Medical Research and Opinion (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (acceptedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- attention deficit hyperactivity disorder, disease burden, healthcare resource utilization, psychiatric comorbidity, depression, anxiety disorders, substance abuse, functional disability, disability, quality of life, criminality, debt, ADHD prevalence
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Cross-Sectional Studies, Europe, Female, Humans, Male, Middle Aged, Outpatients, Patient Acceptance of Health Care, Cost of Illness
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