Clinical and Economic Burdens of ADHD Across Developmental Stages: A Review

AI Summary

ADHD imposes substantial healthcare, non-medical, and family-related economic burdens across developmental stages, including diagnostic, treatment, education, occupational, accident, and criminal justice costs.
Families experience reduced occupational productivity, greater caregiving demands, increased healthcare use, and higher rates of depression, anxiety, and stress.
Clinical practice should assess functional and family-level burden, identify and treat comorbidities, and maintain treatment during transitions to adult services while monitoring tolerability.

TL;DR (AI Generated)

Background: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that can persist across the lifespan and is associated with substantial clinical, economic, and psychosocial burden.

This narrative review examines the clinical and economic burdens of ADHD on individuals and families, encompassing direct medical costs, including assessment and treatment expenditures, alongside non-medical costs, educational and occupational disruption, caregiving demands, and adverse mental health outcomes among family members.

Evidence was synthesized narratively across direct medical, non-medical, and family-related burdens, prioritizing large population-based and administrative claims studies, longitudinal investigations, systematic reviews, and meta-analyses.

Basic summary

J Clin Med. 2026 Nov 6;15(21):8645. doi: 10.3390/jcm15218645.

ABSTRACT

Background: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that can persist across the lifespan and is associated with substantial clinical, economic, and psychosocial burden. This narrative review examines the clinical and economic burdens of ADHD on individuals and families, encompassing direct medical costs, including assessment and treatment expenditures, alongside non-medical costs, educational and occupational disruption, caregiving demands, and adverse mental health outcomes among family members. It synthesizes evidence across developmental stages and geographic regions and considers the clinical implications of these interconnected burdens. Methods: A structured search of PubMed, Scopus, Web of Science, and Embase, supplemented by reference-list screening, identified English-language publications from January 2000 through June 2026. Evidence was synthesized narratively across direct medical, non-medical, and family-related burdens, prioritizing large population-based and administrative claims studies, longitudinal investigations, systematic reviews, and meta-analyses. Interpretation considered study design, confounding factors, economic perspectives, and differences in cost estimation. Results: ADHD is associated with substantial healthcare, non-medical, and family-related economic costs. Reported costs encompass diagnostic assessment, treatment, comorbidity, and adverse events, alongside educational support, occupational losses, accidents, and criminal justice involvement. Families experience reduced occupational productivity, elevated caregiving demands, greater healthcare utilization, and increased depression, anxiety, and stress. Conclusions: Clinically, these findings support assessing functional and family-level burden alongside symptoms, identifying and managing comorbidities, maintaining treatment during transitions to adult services, and monitoring tolerability. Integrating these burden domains into routine assessment and treatment planning may help identify modifiable drivers of impairment and guide more comprehensive care across the lifespan for patients and their families.

PMID:43030787 | DOI:10.3390/jcm15218645

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