title: Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States.
abstract: OBJECTIVE
  Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental disorders in children in the United States and often persists into adulthood with associated symptomatology and impairments. This article comprehensively reviews studies reporting ADHD-related incremental (excess) costs for children/adolescents and adults and presents estimates of annual national incremental costs of ADHD.
  
  
  METHODS
  A systematic search for primary United States-based studies published from January 1, 1990 through June 30, 2011 on costs of children/adolescents and adults with ADHD and their family members was conducted. Only studies in which mean annual incremental costs per individual with ADHD above non-ADHD controls were reported or could be derived were included. Per-person incremental costs were adjusted to 2010 U.S. dollars and converted to annual national incremental costs of ADHD based on 2010 U.S. Census population estimates, ADHD prevalence rates, number of household members, and employment rates by age group.
  
  
  RESULTS
  Nineteen studies met the inclusion criteria. Overall national annual incremental costs of ADHD ranged from $143 to $266 billion (B). Most of these costs were incurred by adults ($105 B-$194 B) compared with children/adolescents ($38 B-$72 B). For adults, the largest cost category was productivity and income losses ($87 B-$138 B). For children, the largest cost categories were health care ($21 B-$44 B) and education ($15 B-$25 B). Spillover costs borne by the family members of individuals with ADHD were also substantial ($33 B-$43 B).
  
  
  CONCLUSIONS
  Despite a wide range in the magnitude of the cost estimates, this study indicates that ADHD has a substantial economic impact in the United States. Implications of these findings and future directions for research are discussed.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, USA. jdoshi@mail.med.upenn.edu
authors.forename: Jalpa A
authors.initials: JA
authors.lastname: Doshi
authors.forename: Paul
authors.initials: P
authors.lastname: Hodgkins
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kahle
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cangelosi
authors.forename: Juliana
authors.initials: J
authors.lastname: Setyawan
authors.forename: M Haim
authors.initials: MH
authors.lastname: Erder
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Neumann
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000191:economics*; D002648:Child; D006801:Humans; D014481:United States