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The impact of ADHD symptoms and global impairment in childhood on working disability in mid-adulthood: a 28-year follow-up study using official disability pension records in a high-risk in-patient population

DOI: 10.1186/1471-244x-12-174

Keywords: ADHD, Conduct disorder, CGAS, Disability pension award

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Abstract:

Former Norwegian child-psychiatric in-patients (n = 257) were followed up 17–39 years after hospitalization by record linkage to the Norwegian national registry of disability pension (DP) awards. Based on the hospital records, the patients were re-diagnosed according to ICD-10. Associations between the diagnoses, other baseline factors and subsequent DP were investigated using Kaplan–Meier survival analyses and logrank testing.At follow-up, 19% of the participants had received a DP award. In the logrank testing, ADHD was the only disorder associated with a subsequent DP, with 30% being disabled at follow-up (p = 0.01). Low psychosocial functioning (assessed by the Children’s Global Assessment Scale) at admission uniquely predicted future DP (p = 0.04).ADHD in childhood was highly associated with later receiving a DP. Our finding of worse prognosis in ADHD compared with other internalizing and externalizing disorders in mid-adulthood supports the assumption of ADHD being specifically linked to working disability. Assessment of psychosocial functioning in addition to diagnostic features could enhance prediction of children who are most at risk of future disability.Attention-deficit/hyperactivity disorder (ADHD) is generally recognized as a neurodevelopmental disorder with executive function deficits [1,2]. In numerous studies, ADHD symptoms have been found to be uniquely related to future academic difficulties, both in population-based studies [3-5], and in clinical follow-up studies [6-9]. However, in these studies, children have been followed only into adolescence and early adulthood [6-9]. This makes it difficult to conclude about the persisting disabling nature of ADHD symptoms. In general, there is a decline in ADHD symptoms into adulthood, but some symptoms (inattention) seem to persist [9,10]. To understand the long-term developmental course of ADHD, knowledge about vocational outcome in mid-life is of interest. Despite several community studies reporting work

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