Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood
Open accessAbstract
Background: Preschool hyperactivity is an early risk factor for adult mental health problems and criminality. Little is known about; (a) the patterns of long‐term service costs associated with this behavioural marker in the general population and (b) the specific factors predicting hyperactivity‐related costs. We undertook a prospective study investigating associations between preschool hyperactivity and average individual annual service costs up to late adolescent and young adulthood. Methods: One‐hundred and seventy individuals rated as hyperactive by their parents and 88 nonhyperactive controls were identified from a community sample of 4,215 three years olds. Baseline information about behaviour/emotional problems and background characteristics were collected. At follow‐up (when individuals were aged between 14 and 25 years) information was obtained on service use, and associated costs since the age of three. Based on this information we calculated the average cost per annum incurred by each individual. Results: Compared to controls, preschoolers with hyperactivity had 17.6 times higher average costs per annum across domains (apart from nonmental health costs). These were £562 for each hyperactive individual compared with £30 for controls. Average annual costs decreased as a function of age, with higher costs incurred at younger ages. The effects of hyperactivity remained significant when other baseline factors were added to the model. Effects were fully mediated by later psychiatric morbidity. When the hyperactive group were examined separately, costs were consistently predicted by male gender and, for some cost codes, by conduct problems. Conclusions: Preventative approaches targeting early hyperactivity may be of value. Services should be targeted towards high‐risk individuals with careful consideration given to the cost‐to‐benefit trade‐off of early intervention strategies.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Even if early risk factors are present, in the absence of additional hits, a disorder may not develop.
“Even if early risk factors (e.g.genetic risk or early environmental factors such as severe deprivation) are present, in the absence of additional “hits”, a disorder ultimately may not develop.”
From Preventive strategies for mental health (2018) · cites this paper as [21]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117 · see citing works
The worldwide prevalence of ADHD: a systematic review and metaregression analysis
Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.6.942 · Cited by 5,346 · see citing works
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12381 · Cited by 3,990 · see citing works
Sonuga-Barke, E. J. S., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., Stevenson, J., Danckaerts, M., van der Oord, S., Döpfner, M., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.12070991 · Cited by 1,167 · see citing works
Self-citationFergusson, D. M., John Horwood, L., & Ridder, E. M. (2005) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00387.x · Cited by 946 · see citing works
Deprivation and Health in Scotland
Thunhurst, C. (1992) · Journal of Epidemiology & Community Health · doi:10.1136/jech.46.1.87 · Cited by 824 · see citing works
Slade, M., & Thornicroft, G. (2025) · doi:10.1093/med/9780198898818.003.0007 · Cited by 679 · see citing works
Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W., Holtmann, M., Santosh, P., Stevenson, J., Stringaris, A., et al. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.12.010 · Cited by 627 · cited 2× · see citing works
“Behavioural parent training was, however, of value in relation to co-occurring conduct problems (Daley et al., 2014) and cognitive training helped ADHD-related neuropsychological deficits (Cortese et al., 2015).”
BackgroundSelf-citationThe quality of life of children with attention deficit/hyperactivity disorder: a systematic review
Danckaerts, M., Sonuga-Barke, E. J. S., Banaschewski, T., Buitelaar, J., Döpfner, M., Hollis, C., Santosh, P., Rothenberger, A., Sergeant, J., Steinhausen, H.-C., et al. (2010) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-009-0046-3 · Cited by 516 · see citing works
Self-citationChisholm, D., Knapp, M. R. J., Knudsen, H. C., Amaddeo, F., Gaite, L., van Wijngaarden, B., & EPSILON Study Group (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.39.s28 · Cited by 480 · see citing works
Pre-school to School: a Behavioural Study
Sturge, J. C. (1983) · Archives of Disease in Childhood · doi:10.1136/adc.58.5.398-a · Cited by 455 · see citing works
Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States
Doshi, J. A., Hodgkins, P., Kahle, J., Sikirica, V., Cangelosi, M. J., Setyawan, J., Erder, M. H., & Neumann, P. J. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.07.008 · Cited by 440 · see citing works
Multiple regression of cost data: use of generalised linear models
Barber, J., & Thompson, S. (2004) · Journal of Health Services Research & Policy · doi:10.1258/1355819042250249 · Cited by 404 · see citing works
Daley, D., van der Oord, S., Ferrin, M., Danckaerts, M., Doepfner, M., Cortese, S., & Sonuga-Barke, E. J. S. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.05.013 · Cited by 401 · see citing works
Self-citationChronis, A. M., Lahey, B., Pelham, W., Williams, S. H., Baumann, B. L., Kipp, H. L., Jones, H. A., & Rathouz, P. (2007) · Developmental Psychology · doi:10.1037/0012-1649.43.1.70 · Cited by 376 · see citing works
Banaschewski, T., Coghill, D., Santosh, P., Zuddas, A., Asherson, P., Buitelaar, J., Danckaerts, M., Döpfner, M., Faraone, S. V., Rothenberger, A., et al. (2006) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-006-0549-0 · Cited by 375 · see citing works
Self-citationSonuga‐Barke, E. J. S., & Halperin, J. M. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02195.x · Cited by 320 · see citing works
Self-citationA systematic review of prospective studies on attention problems and academic achievement
Polderman, T. J. C., Boomsma, D. I., Bartels, M., Verhulst, F. C., & Huizink, A. C. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01568.x · Cited by 303 · see citing works
Pre-school to school: A behavioural study.
Richman, N., Stevenson, J. L., & Graham, P. J. (1982) · Academic Press eBooks · Cited by 298 · see citing works
A TWELVE-YEAR FOLLOW-UP OF PRESCHOOL HYPERACTIVE CHILDREN
McGee, R. O., Partridge, F. M., Williams, S., & Silva, P. A. (1991) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199103000-00010 · Cited by 254 · see citing works
Development of activity level in children.
Routh, D. K., Schroeder, C. S., & O’Tuama, L. A. (1974) · Developmental Psychology · doi:10.1037/h0035993 · Cited by 208 · see citing works
The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010
Erskine, H. E., Ferrari, A. J., Polanczyk, G. V., Moffitt, T. E., Murray, C. J. L., Vos, T., Whiteford, H. A., & Scott, J. G. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12186 · Cited by 207 · see citing works
The effects of childhood ADHD on adult labor market outcomes
Fletcher, J. M. (2014) · Health Economics · doi:10.1002/hec.2907 · Cited by 205 · see citing works
Kessler, R. C., Lane, M., Stang, P. E., & Van Brunt, D. L. (2009) · Psychological Medicine · doi:10.1017/s0033291708003309 · Cited by 183 · see citing works
Hard-to-Manage Preschool Boys: Symptomatic Behavior across Contexts and Time
Campbell, S. B. G., Pierce, E. W., March, C. L., Ewing, L. J., & Szumowski, E. K. (1994) · Child Development · doi:10.1111/j.1467-8624.1994.tb00787.x · Cited by 156 · see citing works
Preventive Interventions for ADHD: A Neurodevelopmental Perspective
Halperin, J. M., Bedard, A., & Curchack, J. T. (2012) · Neurotherapeutics · doi:10.1007/s13311-012-0123-z · Cited by 151 · see citing works
Early detection and intervention for attention-deficit/hyperactivity disorder
Sonuga-Barke, E. J., Koerting, J., Smith, E., McCann, D. C., & Thompson, M. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.39 · Cited by 150 · see citing works
A comparison of two methods of collecting economic data in primary care
Patel, A., Rendu, A., Moran, P., Leese, M., Mann, A., & Knapp, M. (2005) · Family Practice · doi:10.1093/fampra/cmi027 · Cited by 149 · see citing works
Cussen, A., Sciberras, E., Ukoumunne, O. C., & Efron, D. (2011) · European Journal of Pediatrics · doi:10.1007/s00431-011-1524-4 · Cited by 146 · see citing works
Long-term criminal outcome of children with attention deficit hyperactivity disorder
Dalsgaard, S., Mortensen, P. B., Frydenberg, M., & Thomsen, P. H. (2013) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.1860 · Cited by 141 · see citing works
Le, H. H., Hodgkins, P., Postma, M. J., Kahle, J. S., Sikirica, V., Setyawan, J., Erder, M. H., & Doshi, J. A. (2013) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-013-0477-8 · Cited by 139 · see citing works
International Variation in Treatment Procedures for ADHD: Social Context and Recent Trends
Hinshaw, S. P., Scheffler, R. M., Fulton, B. D., Aase, H., Banaschewski, T., Cheng, W., Mattos, P., Holte, A., Lévy, F., Sadeh, A., et al. (2011) · Psychiatric Services · doi:10.1176/ps.62.5.pss6205_0459 · Cited by 130 · see citing works
Larsson, H., Sariaslan, A., Långström, N., D'Onofrio, B., & Lichtenstein, P. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12140 · Cited by 126 · see citing works
Kan, K.-J., Dolan, C., Nivard, M., Middeldorp, C., van Beijsterveldt, C. V., Willemsen, G., & Boomsma, D. (2013) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1016/j.jaac.2012.10.009 · Cited by 116 · see citing works
Beecham, J. K. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12216 · Cited by 112 · see citing works
Sarver, D. E., McCart, M. R., Sheidow, A. J., & Letourneau, E. J. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12249 · Cited by 106 · see citing works
Stevenson, J., Buitelaar, J., Cortese, S., Ferrin, M., Konofal, E., Lecendreux, M., Simonoff, E., Wong, I. C. K., & Sonuga‐Barke, E. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12215 · Cited by 106 · see citing works
Self-citationResource-Use Measurement Based on Patient Recall: Issues and Challenges for Economic Evaluation
Thorn, J. C., Coast, J., Cohen, D. R., Hollingworth, W., Knapp, M. R. J., Noble, S., Ridyard, C. H., Wordsworth, S., & Hughes, D. A. (2013) · Applied Health Economics and Health Policy · doi:10.1007/s40258-013-0022-4 · Cited by 104 · see citing works
Washbrook, E., Propper, C., & Sayal, K. (2013) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.123562 · Cited by 104 · see citing works
Self-citationByford, S., Leese, M., Knapp, M. R. J., Seivewright, H., Cameron, S., Jones, V., Davidson, K. M., & Tyrer, P. J. (2006) · Health Economics · doi:10.1002/hec.1175 · Cited by 86 · see citing works
Recall Strategies and Memory for Health-Care Visits
Jobe, J. B., White, A. A., Kelley, C. L., Mingay, D. J., Sanchez, M. J., & Loftus, E. F. (1990) · Milbank Quarterly · doi:10.2307/3350095 · Cited by 86 · see citing works
Cost-utility of brief psychological treatment for depression and anxiety
Roijen, L. H., van Straten, A., Al, M., Rutten, F., & Donker, M. H. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.188.4.323 · Cited by 71 · see citing works
Patterns of behaviour problems among pre-school children
Sonuga-Barke, E. J. S., Thompson, M. J. J., Stevenson, J., & Viney, D. (1997) · Psychological Medicine · doi:10.1017/s0033291797005291 · Cited by 71 · see citing works
Self-citationGoering, P. N. (1995) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)90145-0 · Cited by 68 · see citing works
Childhood attention problems and socioeconomic status in adulthood: 18-year follow-up
Galéra, C., Bouvard, M. P., Lagarde, E., Michel, G., Touchette, É., Fombonne, E. J., & Melchior, M. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.102491 · Cited by 63 · see citing works
Estimating the costs of ongoing care for adolescents with attention-deficit hyperactivity disorder
Telford, C., Green, C., Logan, S., Langley, K., Thapar, A., & Ford, T. J. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0530-9 · Cited by 62 · see citing works
Conners Comprehensive Behavior Rating Scales
Golden, C. J., & Link, J. (2017) · The SAGE Encyclopedia of Abnormal and Clinical Psychology · doi:10.4135/9781483365817.n329 · Cited by 62 · see citing works
D’Amico, F., Knapp, M. R. J., Beecham, J. K., Sandberg, S. T., Taylor, E. A., & Sayal, K. S. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.131367 · Cited by 60 · see citing works
Self-citationDunne, E. M., Hearn, L. E., Rose, J. J., & Latimer, W. W. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.07.009 · Cited by 57 · see citing works
The Impact of Persisting Hyperactivity on Social Relationships
Moyá, J., Stringaris, A. K., Asherson, P. J., Sandberg, S. T., & Taylor, E. A. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712436876 · Cited by 51 · see citing works
Predictors of and barriers to service use for children at risk of ADHD: longitudinal study
Sayal, K. S., Mills, J. K. A., White, K., Merrell, C. H., & Tymms, P. B. (2014) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-014-0606-z · Cited by 44 · see citing works
Self-citationMirandola, M., Bisoffi, G., Bonizzato, P., & Amaddeo, F. (1999) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050173 · Cited by 42 · see citing works
Marks, D. J., Mlodnicka, A., Bernstein, M., Chacko, A., Rose, S., & Halperin, J. M. (2008) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn112 · Cited by 40 · see citing works
Gesundheitsökonomie der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung in Deutschland
Schlander, M., Trott, G. E., & Schwarz, O. (2009) · Der Nervenarzt · doi:10.1007/s00115-009-2888-9 · Cited by 37 · see citing works
Do Symptoms of ADHD at Ages 7 and 10 Predict Academic Outcome at Age 16 in the General Population?
Holmberg, K., & Bölte, S. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712452136 · Cited by 31 · see citing works
Collecting service use data for economic evaluation in DSPD populations
Barrett, B. M., & Byford, S. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.190.5.s75 · Cited by 27 · see citing works
Schlander, M., Trott, G.-E., & Schwarz, O. (2010) · Der Nervenarzt · Cited by 24 · see citing works
Kotsopoulos, N., Connolly, M. P., Sobanski, E., & Postma, M. J. (2013) · PubMed · Cited by 18 · see citing works
Rutter’s Child & Adolescent Psychiatry
Yule, W., & Smith, P. A. (2008) · Blackwell publishing · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Dartington, T.S.R.U.A. (2013). Investing in children: Technical report. In T. E. A. G. Bjornstad (Ed.). Dartington: Dartington Press.
- National Institute for Health and Care Excellence (2009). Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults. London: NICE. 29634174
Cited by
Sorted by citations
ADHD in Children and Young People: Prevalence, Care Pathways, and Service Provision
Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30167-0 · Cited by 1,223 · see citing works
Self-citationKennedy, M., Kreppner, J., Knights, N., Kumsta, R., Maughan, B., Golm, D., Rutter, M., Schlotz, W., & Sonuga‐Barke, E. J. S. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12576 · Cited by 106 · see citing works
Self-citationDaley, D., Jacobsen, R. H., Lange, A.-M., Sørensen, A., & Walldorf, J. (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2019.06.011 · Cited by 67 · see citing works
- Authors
- Chorozoglou, M., Smith, E., Koerting, J., Thompson, M. J., Sayal, K., & Sonuga‐Barke, E. J. S.
- Affiliations
- University of Southampton (GB)
- University of Bath (GB)
- University of Nottingham (GB)
- Developmental Brain‐Behaviour Laboratory Department of Psychology University of Southampton Southampton UK
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2015-06-13
- Volume
- 56
- Issue
- 9
- Pages
- 966-975
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC4744758
- OpenAlex
- W1526727491
- Cited by
- 77
- References
- 59
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 13 · 2017: 15 · 2016: 9
- FWCI
- 10.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, cc-by-nc-nd)
- Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by-nc-nd)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- The University of Bath Online Publications Store (The University of Bath) (submittedVersion, cc-by-nc-nd)
- Pure (University of Bath) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health Research (RP-PG-0108-10061)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- economic burden, health care costs, psychiatric morbidity, conduct problems, early intervention, child behavior problems, gender differences
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, England, Female, Humans, Longitudinal Studies, Male, Sex Factors, Health Care Costs, Attention Deficit and Disruptive Behavior Disorders, Young Adult
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 ›
Are you an author, or do you see a problem with this page? Request a review
