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. 2015 Jul 6;10(7):e0132233.
doi: 10.1371/journal.pone.0132233. eCollection 2015.

Sociodemographics, Comorbidities, Healthcare Utilization and Work Productivity in Japanese Patients with Adult ADHD

Eiji Kirino  1 , Hideyuki Imagawa  2 , Taro Goto  2 , William Montgomery  3
Affiliations

Sociodemographics, Comorbidities, Healthcare Utilization and Work Productivity in Japanese Patients with Adult ADHD

Eiji Kirino et al. PLoS One. .

Abstract

Objectives: This study compared the sociodemographic characteristics, comorbidities, healthcare resource utilization, and work productivity among Japanese adults who reported being diagnosed with attention-deficit/hyperactivity disorder (ADHD) to those of a non-ADHD control population.

Methods: Data for this study were captured from an online survey of adults in Japan conducted by Kantar Health using consumer panels. A total of 84 survey participants reported they had received a diagnosis of ADHD from a physician. Survey responses pertaining to functional status and resource utilization from this ADHD group were compared to those from a non-ADHD control group of 100 participants. Comparisons between the ADHD and non-ADHD groups were made using chi-square tests for categorical variables and t-tests for continuous variables.

Results: Participants in the ADHD group were on average slightly younger with a higher proportion of males. ADHD respondents reported significantly more comorbid depression, sleep difficulties, headaches, and anxiety than non-ADHD controls. Over the previous 6 months, the ADHD group made more visits to healthcare providers and the emergency room, and had more hospitalizations than non-ADHD controls. The ADHD group also rated their overall health status lower than the non-ADHD control group. Respondents with ADHD reported a significantly higher degree of health-related work impairment compared to non-ADHD, with greater absenteeism and decreased work productivity. The ADHD group indicated their symptoms negatively impacted relationships, self-esteem, and regular daily activities.

Conclusions: Japanese adults with ADHD face a substantial burden of illness, including lower overall health status, increased number of comorbidities, greater healthcare utilization, and significant health-related occupational impairment compared to those without ADHD. Additional research is needed to develop a better understanding of both the consequences and treatment approaches for Japanese adults with ADHD.

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Conflict of interest statement

Competing Interests: Eli Lilly Japan K.K. provided funds to Kantar Health for the conduct of the web-based survey, data management and data analysis, and to Strategic Health Outcomes, Inc., for writing and editorial assistance. Hideyuki Imagawa and Taro Goto are employed by Eli Lilly Japan K.K. and William Montgomery by Eli Lilly Australia Pty Ltd. All are minor stockholders of Eli Lilly and Company. The specific roles of these authors are articulated in the author contributions section. Eli Lilly is the patent holder and marketing sponsor of Strattera (atomoxetine hydrochloride, patent number 5.658.590). There are no other patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Fig 1
Fig 1. Comorbid Central Nervous System-related Conditions Reported over the Past 12 Months.
In this self-report survey, the ADHD group consisted of patients who reported being diagnosed with ADHD by a physician. The ADHD group reported a significantly greater number of comorbid CNS-related conditions when compared to the non-ADHD control group. In particular, depression and general anxiety in the ADHD group occurred at a rate that was approximately 60- and 40-fold greater than non-ADHD controls, respectively. Abbreviations: ADHD = attention-deficit/hyperactivity disorder; CNS = central nervous system; GAD = Generalized Anxiety Disorder; OCD = Obsessive-Compulsive Disorder; PD = Panic Disorder; SAD = Social Anxiety Disorder. *p < 0.05.
Fig 2
Fig 2. Healthcare Visits over the Past 6 Months.
In this self-report survey, the ADHD group consisted of patients who reported being diagnosed with ADHD by a physician. Participants in the ADHD group had significantly more healthcare provider visits, emergency room visits, and hospitalizations when compared to the non-ADHD control group. The ADHD group reported total physician visits at a rate that was 10 times greater, and emergency room visits and hospitalizations at a rate that was approximately 3 times greater than the control group. Abbreviation: ADHD = attention-deficit/hyperactivity disorder; ER = emergency room. *p < 0.05.
Fig 3
Fig 3. Participants Self-rated General Health Status.
In this self-report survey, the ADHD group consisted of patients who reported being diagnosed with ADHD by a physician. The mean self-rated health status was 3.6 (SD 1.2) for the ADHD group and 3.0 (SD 0.8) for the non-ADHD control group (p < 0.05). Nearly 3 times as many participants in the ADHD group perceived their health status as being either “poor” or “fair” compared to the control group. Abbreviation: ADHD = attention-deficit/hyperactivity disorder.
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