An analysis of data from the Swedish Total Population Register revealed that individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) were more likely to move their place of residence, change jobs and have unstable romantic relationships. Women with this disorder of all age groups were more likely to have unstable romantic relationships compared to men. The study was published in BMC Psychiatry.
ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that significantly impact daily functioning and quality of life. Individuals with ADHD may struggle with maintaining focus, organizing tasks, regulating impulses, may display restlessness or excessive activity. While it commonly starts in childhood, ADHD can persist into adulthood.
Previous studies on ADHD have mainly focused on children and teenagers, but recent research suggests that adults with ADHD face challenges in different areas of life as well. For example, studies have shown that adults with ADHD tend to have lower income, more relationship problems, and difficulties in responding constructively to their partner’s behavior. They also tend to move residences more frequently, often due to financial problems.
Study author Rickard Ahlberg and his colleagues note that most of these studies were conducted on limited samples and mainly on young adults. These researchers wanted to verify these findings on a larger, national sample. They decided to use the large national registers available in Sweden for this purpose.
The researchers analyzed data from the Swedish Total Population Register. The register contained information on over 3 million individuals born between 1948 and 1982. The researchers linked this data to several other registers that provided information on employment, education, healthcare, and prescriptions.
To identify individuals with ADHD, the researchers looked for at least one ADHD diagnosis in the National Patient Register or evidence of being prescribed ADHD medication at least four times. Researchers used the Integrated Database for Labor Market Research register to obtain the information of the extent to which an individual has changed jobs between two consecutive years (job shifting) and about how many times they moved their place of residence in the study period (2000-2014).
Relationship instability was assessed by registering how many children individuals had with different partners in the period followed in the study. This was obtained from the Multi Generation Register. Additionally, the researchers included data on diagnoses of substance use disorder, borderline personality disorder, and criminal convictions in their analyses.
Results showed that 17,088 men (or 0.91%) of men in the register and 13,993 women (or 0.84%) had a diagnosis of ADHD during the study period. Of these participants, 40% suffered from the substance use disorder and 9.8% suffered from the borderline personality disorder. This was many times higher than in the population without ADHD, where 4.6% suffered from substance use disorder and 0.5% from the borderline personality disorder. Parents of individuals with ADHD had lower income on average compared to parents of individuals without ADHD.
Adults with ADHD moved their place of residence more than twice as often as individuals without ADHD. They also tended to have children with different partners more often (relationship instability) and change jobs more often, but these rates were just a bit higher than among individuals without ADHD.
All these differences were stronger in older age groups (30-52 years of age at the start of the study). Younger individuals with ADHD, those between 18-29 years of age at the start of the study, did not change jobs or have children by different partners more often than individuals without ADHD.
Women with ADHD between 18 and 29 years of age had an 18% higher rate of relational instability (i.e., children with different partners) compared to men with ADHD. They also changed their places of residence more often than men with ADHD.
“Both men and women with a diagnosis of ADHD present with an increased risk of real-life instability in different domains; a behavioral pattern that is not limited to childhood or adolescence but also exists well into adulthood,” the study authors concluded.
The study makes an important contribution to the scientific understanding of the consequences of ADHD in adults. However, it also has limitations that need to be taken into account. Notably, the study was based on official registers only. These registers contain data only from individuals who seek treatment. That is the likely reason why the share of people with ADHD reported in this study is much lower than those reported in studies that included diagnostics of ADHD in the scope of the study (these studies report around 2.5% of participants with ADHD). Additionally, all three measures of life instability were very crude and unable to capture individual nuances of events they registered.
The paper, “Real-life instability in ADHD from young to middle adulthood: a nationwide register-based study of social and occupational problems”, was authored by Rickard Ahlberg, E. Du Rietz, E. Ahnemark, L. M. Andersson, T. Werner-Kiechle, P. Lichtenstein, H. Larsson, and M. Garcia-Argibay.