Abstract
BackgroundThis observational, cross-sectional, retrospective chart review aimed to identify factors determining health-related quality of life (HRQoL) in adults with newly diagnosed attention-deficit/hyperactivity disorder (ADHD) in Sweden.MethodsAdult participants with a new clinical diagnosis of ADHD were enrolled from two specialist outpatient clinics in Stockholm, Sweden, from 2013 to 2015. Data extracted from patient records included demographics, clinical characteristics and comorbid psychiatric diagnoses identified using the Mini International Neuropsychiatric Interview (MINI). Depression severity was assessed using the Montgomery–Åsberg Depression Rating Scale – Self-reported (MADRS-S). The self-rated five-dimension EuroQol questionnaire (EQ-5D) was used to measure HRQoL. Predictors of EQ-5D index score were identified using multivariate linear regression adjusting for age, sex, education level, and main income source.ResultsThe mean age of the 189 enrolled patients was 35.2 years (standard deviation [SD], 12.3), and 107 (57%) were female. Psychiatric comorbidities were present in 92 patients (49%), with anxiety and depression being the most common diagnoses. The mean EQ-5D index score was 0.63 (SD, 0.28). Low EQ-5D index scores were significantly associated with high MADRS-S scores, multiple comorbid psychiatric disorders, low educational achievement, female sex, and not having a main income derived from employment or self-employment.ConclusionsThese findings suggest that adults with newly diagnosed ADHD experience low HRQoL, which may often be exacerbated by psychiatric comorbidities such as anxiety and depression. Patients presenting with ADHD and psychiatric comorbidities in adulthood may require particular care and resources in the management of their ADHD.
Highlights
This observational, cross-sectional, retrospective chart review aimed to identify factors determining health-related quality of life (HRQoL) in adults with newly diagnosed attention-deficit/hyperactivity disorder (ADHD) in Sweden
Delays in diagnosis were apparent if the signs and symptoms of ADHD were attributed to other psychiatric disorders, for example, anxiety disorders, which often co-occur with ADHD [11]
Montgomery–Åsberg Depression Rating Scale – Self-reported (MADRS-S) score was the strongest predictor of 5dimension EuroQol questionnaire (EQ-5D) index score, implying an association between severe depression and poor HRQoL in adult patients with ADHD
Summary
This observational, cross-sectional, retrospective chart review aimed to identify factors determining health-related quality of life (HRQoL) in adults with newly diagnosed attention-deficit/hyperactivity disorder (ADHD) in Sweden. Attention-deficit/hyperactivity disorder (ADHD) is estimated to affect between 2.5 and 5.0% of adults worldwide [1,2,3]. Delays in diagnosis were apparent if the signs and symptoms of ADHD were attributed to other psychiatric disorders, for example, anxiety disorders, which often co-occur with ADHD [11]. These findings highlight the need for increased recognition and understanding of ADHD as an adult psychiatric disorder. The European Network Adult ADHD published a consensus document in 2010, with the aims of increasing awareness of ADHD in adults and improving patient care across Europe [12]
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