Adult ADHD leads to more accidents and poorer performance at work

What happens when children with a diagnosis of attention deficit hyperactivity disorder (ADHD) grow up and go to work? According to Ronald Kessler and colleagues, at least some of them continue to experience cognitive difficulties, thus impairing their work performance and increasing the number of accidents they are involved in.

Kessler's team surveyed 8563 staff, including office and manual workers,  at a major American manufacturing firm. They found 1.9 per cent of them met the criteria for Adult ADHD (based on self-report) and that those with the condition rated their own work performance lower than their colleagues rated theirs, took more time off work sick, and were twice as likely to have had an accident at work during the preceding year.

The results are complicated by the fact that staff with ADHD were also more likely to have depression, chronic pain, insomnia and/or chronic fatigue syndrome than their colleagues. However, adult ADHD was still associated with poorer work performance and more sick leave when the influence of these other conditions was taken into account.

Based on the extra sick leave the staff with ADHD took and their lower work performance, the researchers estimated that each staff member with ADHD was costing their employer $4336 a year in lost revenue.

Only four of the staff with ADHD were currently receiving treatment for their condition. Pointing to research showing the efficacy of drug treatments for Adult ADHD, Kessler and his co-workers argued there was a strong case for the screening and treatment of Adult ADHD at work. "Even if treatment led to no more than a 25 per cent reduction in conservatively estimated human capital loss, the financial value of this reduction would exceed the cost of treatment," they wrote.

It's worth noting that the acknowledgement section of the paper states that the research was funded by the pharmaceutical company Eli Lilly, and that the lead author has acted as a consultant to them. Eli Lilly develop drug treatments for ADHD.
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R. C. Kessler, M. Lane, P. E. Stang, D. L. Van Brunt (2008). The prevalence and workplace costs of adult attention deficit hyperactivity disorder in a large manufacturing firm Psychological Medicine, 39 (01) DOI: 10.1017/S0033291708003309

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