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. 2023 Oct;27(12):1393-1410.
doi: 10.1177/10870547231176862. Epub 2023 Jun 21.

Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review

Blandine French  1 , David Daley  2 , Madeleine Groom  1 , Sarah Cassidy  1
Affiliations

Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review

Blandine French et al. J Atten Disord. 2023 Oct.

Abstract

Background: The two most prevalent neurodevelopmental disorders-Attention Deficit Hyperactivity Disorder (ADHD) and Autism (ASD)-(ASD/ADHD) strongly impact individuals' functions. This is worsened when individuals are undiagnosed and risks such as increased imprisonments, depression or drug misuse are often observed. This systematic review synthesizes the risks associated with late/undiagnosed ASD/ADHD.

Methods: Four databases were searched (Medline, Scopus, PsychInfor, and Embase). Published studies exploring the impact of undiagnosed ASD/ADHD were included. Exclusion criteria included, lack of diagnosis status, studies not solely on ASD or ADHD, gray literature and studies not in English. The findings were summarize through a narrative synthesis.

Results: Seventeen studies were identified, 14 on ADHD and three on ASD. The narrative synthesis identified three main themes: (1) Health, (2) Offending behavior, and (3) Day-to-day impact. The risks highlighted a significant impact on mental wellbeing and social interactions, higher risks of substance abuse, accidents and offending behavior as well as lower levels of income and education.

Discussion: The findings suggest that undiagnosed ASD/ADHD is linked to many risks and negative outcomes affecting individuals, their families, and the wider society. The restricted number of studies on ASD are a limitation to the generalization of these findings Implications for research and practice are discussed, highlighting the importance of screening and acknowledging the possibility of ASD/ADHD in many settings such as psychiatric and forensic.

Keywords: ADHD; ASD; autism; systematic review; undetected; undiagnosed.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Prof Daley reports grants, personal fees and non-financial support from Takeda, personal fees and non-financial support from Medice, personal fees and non-financial support from Eli Lilly. Dr French reports personal fees and nonfinancial support from Takeda and Medice. Dr Groom and Dr Cassidy reports no conflicts of interest.

Figures

Figure 1.
Figure 1.
Study selection flow diagram. *Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). **If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools. Source. Page et al. (2021). For more information, visit: http://www.prisma-statement.org/.
See this image and copyright information in PMC

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