Risk Factors for Disability Pension among Young Adults Diagnosed with Attention-deficit Hyperactivity Disorder (ADHD) in Adulthood

Abstract

Objective: To investigate risk factors of disability pension (DP) in young adults diagnosed with ADHD in Sweden. Method: In total, 9718 individuals diagnosed with incident ADHD in young adult age (19–29 years) 2006 to 2011, were identified through national registers. They were followed for 5 years and Cox regression models were applied to analyze the DP risk (overall and by sex), associated with socio-demographics, work-related factors, and comorbid disorders. Results: Twenty-one percent of all received DP. Being younger at diagnosis (hazard ratio [HR] = 1.54; 95%confidence interval [CI] 1.39–1.71); low educational level (HR = 1.97; 95%CI 1.60–2.43 for <10 years); work-related factors at baseline (no income from work [HR = 2.64; 95%CI 2.35–2.98] and sickness absence >90 days [HR = 2.48; 95%CI2.17–2.83]); and schizophrenia/psychoses (HR = 2.16; 95%CI 1.66–2.80), autism (HR = 1.87; 95%CI 1.42–2.46), anxiety (HR = 1.34; 95%CI 1.22–1.49) were significantly associated with an increased risk of DP. Similar risk patterns were found in men and women. Conclusion: Work-related factors and comorbid mental disorders need to be highlighted in early vocational rehabilitation for individuals with ADHD.

Occupational Branch and Labor Market Marginalization among Young Employees with Adult Onset of Attention Deficit Hyperactivity Disorder—A Population-Based Matched Cohort Study

“…Several studies have reported that individuals with ADHD diagnosed in childhood and young adulthood have difficulties completing their education [ 37 ], as well as entering and staying in the labor market [ 12 , 14 , 17 , 37 , 38 , 39 ]. In this study, individuals were already employed when diagnosed with ADHD [ 14 ], which indicates that they might have been in better health, and had less debilitating ADHD symptoms or better responsiveness to treatment compared with ADHD patients on permanent DP [ 12 ]. However, even in this highly selected group, individuals with ADHD still had a higher risk of LMM compared with those without.…”

“…A large heterogeneity of individuals diagnosed by ADHD, with different degrees of comorbidities and work-related factors, has been described previously [ 17 , 39 , 40 ]. In general ADHD patients with a lower socioeconomic status, such as lower level of education, lower income, living in rural areas and with common mental disorders, had a higher risk of DP and unemployment compared with ADHD patients with higher socioeconomic status and without mental comorbidities [ 14 , 17 , 39 ]. Comorbid mental disorders might contribute to worse LMM by impairing adherence to treatment [ 40 , 41 ], but they can also directly affect workability [ 42 , 43 , 44 ].…”

“…Previous studies on young adults with mental disorders reported that many have problems of entering and being able to stay in the labor market [ 9 , 10 , 13 ]. Young adults with ADHD have more sickness absence (SA) days if working and a higher risk of being on disability benefit or unemployed compared with young adults without ADHD [ 11 , 13 , 14 , 15 , 16 , 17 ]. Lower socioeconomic status such as a low level of education, living in more rural settings [ 14 , 17 ] and having comorbid mental disorders [ 14 , 15 , 16 ] predicts a higher risk of work disability among individuals with ADHD diagnosed in adulthood.…”

“…Young adults with ADHD have more sickness absence (SA) days if working and a higher risk of being on disability benefit or unemployed compared with young adults without ADHD [ 11 , 13 , 14 , 15 , 16 , 17 ]. Lower socioeconomic status such as a low level of education, living in more rural settings [ 14 , 17 ] and having comorbid mental disorders [ 14 , 15 , 16 ] predicts a higher risk of work disability among individuals with ADHD diagnosed in adulthood. Being a woman and previous long-term SA is also identified as predictors for long-term work disability among young individuals with ADHD [ 14 ].…”

“…Lower socioeconomic status such as a low level of education, living in more rural settings [ 14 , 17 ] and having comorbid mental disorders [ 14 , 15 , 16 ] predicts a higher risk of work disability among individuals with ADHD diagnosed in adulthood. Being a woman and previous long-term SA is also identified as predictors for long-term work disability among young individuals with ADHD [ 14 ]. However, it is not known whether there is any difference among occupational branches, such as manufacturing, construction, trade and communication, financial and business services, education and research, and health and social work, in relation to adverse labor market outcomes for young employees who have entered the labor market and who have been diagnosed with ADHD during young adulthood.…”