The Prevalence and Effects of Adult Attention Deficit/Hyperactivity Disorder on Work Performance in a Nationally Representative Sample of Workers
Abstract
OBJECTIVE: The prevalence and workplace consequences of adult attention deficit/hyperactivity disorder (ADHD) are unknown. METHODS: An ADHD screen was included in a national household survey (n = 3198, ages 18-44). Clinical re-interviews calibrated the screen to diagnoses of Diagnostic and Statistical Manual of Mental Disorders, 4th edition ADHD. Diagnoses among workers were compared with responses to the WHO Health and Work Performance Questionnaire (HPQ). RESULTS: A total of 4.2% of workers had ADHD. ADHD was associated with 35.0 days of annual lost work performance, with higher associations among blue collar (55.8 days) than professional (12.2 days), technical (19.8 days), or service (32.6 days) workers. These associations represent 120 million days of annual lost work in the U.S. labor force, equivalent to dollar 19.5 billion lost human capital. CONCLUSIONS: ADHD is a common and costly workplace condition. Effectiveness trials are needed to estimate the region of interest of workplace ADHD screening and treatment programs.
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ADHD is associated with substantial individual impacts such as difficulties in interpersonal functioning, educational and occupational performance, and community activities.
“it is associated with substantial individual impacts such as difficulties in interpersonal functioning, educational and occupational performance, and community activities [6-9].”
Prevalence of ADHD in adults estimated from epidemiological studies is 2-5%.
“The prevalence of ADHD in adults estimated from epidemiological studies is in the range of 2-5% [16-19].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [18]
Long-term follow-up, epidemiological, and clinical studies have shown that adults with untreated ADHD, compared to normal controls, experience higher rates of academic failure, low occupational status, increased risk of substance use disorders, accidents, and delinquency, and have fewer social relationships or friends.
“Long-term follow-up, epidemiological and clinical studies have shown that adults with untreated ADHD, when compared to normal controls, experience higher rates of academic failure, low occupational status, increased risk of substance use disorders (tobacco, alcohol or drugs), accidents and delinquency, and have fewer social relationships or friends [18,121,127,131,243,244].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [18]
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“These measures are of particular relevance to the patient population, which faces a serious disruption to life domains [8-10 ,”
Background
- Authors
- Kessler, R. C., Adler, L., Ames, M., Barkley, R. A., Birnbaum, H., Greenberg, P., Johnston, J. A., Spencer, T., & ??st??n, T. B.
- Affiliations
- Harvard University (US)
- Corresponding author
- Kessler, Ronald C.
- Venue
- Journal of Occupational and Environmental Medicine
- Published
- 2005-06
- Volume
- 47
- Issue
- 6
- Pages
- 565-572
- ISSN
- 1076-2752 (ISSN-L)
- OpenAlex
- W2154077719
- Cited by
- 335
- References
- 45
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 3 · 2023: 9 · 2022: 11 · 2021: 11 · 2020: 6 · 2019: 11 · 2018: 13 · 2017: 11 · 2016: 20 · 2015: 16 · 2014: 24 · 2013: 18 · 2012: 33
- FWCI
- 11.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Occupational and Environmental Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Substance Abuse and Mental Health Services Administration
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (R01DA016558)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Social Sciences › Safety Research › Disability Education and Employment
- Keywords
- adult ADHD, ADHD prevalence, employee performance, productivity loss, occupational health, blue-collar workers, human capital loss, workplace screening
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Efficiency, Employee Performance Appraisal, Female, Humans, Interviews as Topic, Male, Surveys and Questionnaires, United States, Prevalence, Workplace
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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