The Economic Impact of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pelham, W. E, Foster, E M., & Robb, J. A Journal of Pediatric Psychology, 32(6):711–727, 2007. ![The Economic Impact of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Using a cost of illness (COI) framework, this article examines the economic impact of attention-deficit/ hyperactivity disorder (ADHD) in childhood and adolescence. Our review of published literature identified 13 studies, most conducted on existing databases by using diagnostic and medical procedure codes and focused on health care costs. Two were longitudinal studies of identified children with ADHD followed into adolescence. Costs were examined for ADHD treatment-related and other health care costs (all but 1 study addressed some aspect of health care), education (special education, 2 studies; disciplinary costs: 1 study), parental work loss (2 studies), and juvenile justice (2 studies). Based on this small and as yet incomplete evidence base, we estimated annual COI of ADHD in children and adolescents at $14,576 per individual (2005 dollars). Given the variability of estimates across studies on which that number is based, a reasonable range is between $12,005 and $17,458 per individual. Using a prevalence rate of 5%, a conservative estimate of the annual societal COI for ADHD in childhood and adolescence is $42.5 billion, with a range between $36 billion and $52.4 billion. Estimates are preliminary because the literature is incomplete; many potential costs have not been assessed in extant studies. Limitations of the review and suggestions for future research on COI of ADHD are provided. Key words attention-deficit/hyperactivity disorder; cost of illness; economic impact. Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental health (MH) disorders of childhood; prevalence rates range from 2% to 9%. 1 By definition, children with ADHD lag children of the same age in sustained attention, impulse control, and modulation of activity level. These symptoms begin at an early age, are displayed across environments, and continue throughout the lifespan. 2 Importantly, they lead to a host of limitations within multiple domains of life, including adult relationships (e.g., noncompliance with parent and teacher requests), school functioning (e.g., classroom disruption and poor achievement), and peer and sibling relationships (e.g., annoying, intrusive, overbearing, and aggressive behaviors). These difficulties lead to serious limitations in life functioning not only for the children with ADHD but also for their peers, families, and schools. Further, for the great majority of children with ADHD, these limitations in daily functioning persist across adolescence and into adulthood (e.g., vocational under-achievement, interpersonal problems, substance use, and criminal activity), even though their core symptomatology (e.g., inattention) may improve with age. 3-6 Children and youth with ADHD use services across a range of child-serving systems. The disorder is among the most common referring problems in primary care settings. 7 In the educational system, ADHD is among the most common diagnoses in special educational settings and is the major behavioral problem regular education teachers face. 8 In addition, ADHD is one of the most common diagnoses in MH settings for children. 9 Its high prevalence, chronicity, and substantial impact on daily life functioning for children, their parents, peers, and teachers has made ADHD a major public health concern. 10 As a result, ADHD is arguably the most well-researched MH disorder of childhood. As detailed in
@article{pelham_economic_2007,
title = {The {Economic} {Impact} of {Attention}-{Deficit}/{Hyperactivity} {Disorder} in {Children} and {Adolescents}},
volume = {32},
url = {https://academic.oup.com/jpepsy/article-abstract/32/6/711/1023337},
doi = {10.1093/jpepsy/jsm022},
abstract = {Using a cost of illness (COI) framework, this article examines the economic impact of attention-deficit/ hyperactivity disorder (ADHD) in childhood and adolescence. Our review of published literature identified 13 studies, most conducted on existing databases by using diagnostic and medical procedure codes and focused on health care costs. Two were longitudinal studies of identified children with ADHD followed into adolescence. Costs were examined for ADHD treatment-related and other health care costs (all but 1 study addressed some aspect of health care), education (special education, 2 studies; disciplinary costs: 1 study), parental work loss (2 studies), and juvenile justice (2 studies). Based on this small and as yet incomplete evidence base, we estimated annual COI of ADHD in children and adolescents at \$14,576 per individual (2005 dollars). Given the variability of estimates across studies on which that number is based, a reasonable range is between \$12,005 and \$17,458 per individual. Using a prevalence rate of 5\%, a conservative estimate of the annual societal COI for ADHD in childhood and adolescence is \$42.5 billion, with a range between \$36 billion and \$52.4 billion. Estimates are preliminary because the literature is incomplete; many potential costs have not been assessed in extant studies. Limitations of the review and suggestions for future research on COI of ADHD are provided. Key words attention-deficit/hyperactivity disorder; cost of illness; economic impact. Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental health (MH) disorders of childhood; prevalence rates range from 2\% to 9\%. 1 By definition, children with ADHD lag children of the same age in sustained attention, impulse control, and modulation of activity level. These symptoms begin at an early age, are displayed across environments, and continue throughout the lifespan. 2 Importantly, they lead to a host of limitations within multiple domains of life, including adult relationships (e.g., noncompliance with parent and teacher requests), school functioning (e.g., classroom disruption and poor achievement), and peer and sibling relationships (e.g., annoying, intrusive, overbearing, and aggressive behaviors). These difficulties lead to serious limitations in life functioning not only for the children with ADHD but also for their peers, families, and schools. Further, for the great majority of children with ADHD, these limitations in daily functioning persist across adolescence and into adulthood (e.g., vocational under-achievement, interpersonal problems, substance use, and criminal activity), even though their core symptomatology (e.g., inattention) may improve with age. 3-6 Children and youth with ADHD use services across a range of child-serving systems. The disorder is among the most common referring problems in primary care settings. 7 In the educational system, ADHD is among the most common diagnoses in special educational settings and is the major behavioral problem regular education teachers face. 8 In addition, ADHD is one of the most common diagnoses in MH settings for children. 9 Its high prevalence, chronicity, and substantial impact on daily life functioning for children, their parents, peers, and teachers has made ADHD a major public health concern. 10 As a result, ADHD is arguably the most well-researched MH disorder of childhood. As detailed in},
number = {6},
urldate = {2019-10-28},
journal = {Journal of Pediatric Psychology},
author = {Pelham, William E and Foster, E Michael and Robb, Jessica A},
year = {2007},
pages = {711--727},
}
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Costs were examined for ADHD treatment-related and other health care costs (all but 1 study addressed some aspect of health care), education (special education, 2 studies; disciplinary costs: 1 study), parental work loss (2 studies), and juvenile justice (2 studies). Based on this small and as yet incomplete evidence base, we estimated annual COI of ADHD in children and adolescents at $14,576 per individual (2005 dollars). Given the variability of estimates across studies on which that number is based, a reasonable range is between $12,005 and $17,458 per individual. Using a prevalence rate of 5%, a conservative estimate of the annual societal COI for ADHD in childhood and adolescence is $42.5 billion, with a range between $36 billion and $52.4 billion. Estimates are preliminary because the literature is incomplete; many potential costs have not been assessed in extant studies. Limitations of the review and suggestions for future research on COI of ADHD are provided. Key words attention-deficit/hyperactivity disorder; cost of illness; economic impact. Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental health (MH) disorders of childhood; prevalence rates range from 2% to 9%. 1 By definition, children with ADHD lag children of the same age in sustained attention, impulse control, and modulation of activity level. These symptoms begin at an early age, are displayed across environments, and continue throughout the lifespan. 2 Importantly, they lead to a host of limitations within multiple domains of life, including adult relationships (e.g., noncompliance with parent and teacher requests), school functioning (e.g., classroom disruption and poor achievement), and peer and sibling relationships (e.g., annoying, intrusive, overbearing, and aggressive behaviors). These difficulties lead to serious limitations in life functioning not only for the children with ADHD but also for their peers, families, and schools. Further, for the great majority of children with ADHD, these limitations in daily functioning persist across adolescence and into adulthood (e.g., vocational under-achievement, interpersonal problems, substance use, and criminal activity), even though their core symptomatology (e.g., inattention) may improve with age. 3-6 Children and youth with ADHD use services across a range of child-serving systems. The disorder is among the most common referring problems in primary care settings. 7 In the educational system, ADHD is among the most common diagnoses in special educational settings and is the major behavioral problem regular education teachers face. 8 In addition, ADHD is one of the most common diagnoses in MH settings for children. 9 Its high prevalence, chronicity, and substantial impact on daily life functioning for children, their parents, peers, and teachers has made ADHD a major public health concern. 10 As a result, ADHD is arguably the most well-researched MH disorder of childhood. 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Our review of published literature identified 13 studies, most conducted on existing databases by using diagnostic and medical procedure codes and focused on health care costs. Two were longitudinal studies of identified children with ADHD followed into adolescence. Costs were examined for ADHD treatment-related and other health care costs (all but 1 study addressed some aspect of health care), education (special education, 2 studies; disciplinary costs: 1 study), parental work loss (2 studies), and juvenile justice (2 studies). Based on this small and as yet incomplete evidence base, we estimated annual COI of ADHD in children and adolescents at \\$14,576 per individual (2005 dollars). Given the variability of estimates across studies on which that number is based, a reasonable range is between \\$12,005 and \\$17,458 per individual. 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