While these core symptoms are well-known, ADHD can have far-reaching impacts on an individual’s life beyond these primary features.
It can affect mental and physical health, academic and occupational performance, social relationships, and overall quality of life.
Individuals with ADHD may experience challenges in daily functioning, increased risk of certain health conditions, difficulties in personal relationships, andstruggles with self-esteem.
Key Points
Rationale
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting approximately 5% of children, with symptoms often persisting into adulthood (Polanczyk et al., 2007).
While the core symptoms of inattention, hyperactivity, andimpulsivityare well-established, there is growing recognition that ADHD has wide-ranging impacts on many aspects of an individual’s life.
Previous research has identified associations between ADHD and various adverse outcomes related to mental health, physical health, academic/occupational functioning, and social relationships (Harpin, 2005; Nigg, 2013).
However, the breadth of research on ADHD-related outcomes makes it challenging to synthesize findings comprehensively.
While some previous reviews have attempted to summarize long-term outcomes in ADHD (e.g., Shaw et al., 2012), they have often been limited in scope or focused primarily on treated vs untreated ADHD.
There is a need for an up-to-date, comprehensive synthesis of the wide-ranging impacts associated with ADHD across the lifespan.
By taking this “review of reviews” approach, the authors sought to provide a broad overview of the current state of evidence regarding ADHD-related outcomes across multiple domains of functioning.
This comprehensive synthesis can inform clinical practice, policy development, and future research directions related to ADHD.
Method
This study utilized an umbrella review methodology, following PRISMA guidelines forsystematic reviews.
Five major databases were searched: PsycINFO, Embase, Scopus, Medline, and ERIC. The search was conducted in July 2023 without date restrictions.
Search strategy and terms:
The search strategy was adapted for each database but generally included terms related to ADHD and associated risks/impacts.
A sample search strategy for Medline is provided in the supplementary materials.
Inclusion criteria:
Exclusion criteria:
Statistical measures:
Due to the heterogeneity of included reviews, a narrative synthesis approach was used rather than quantitative meta-analysis.
Two reviewers independently extracted data and assessed the methodological quality of included reviews using standardized tools (JBI critical appraisal checklist for systematic reviews or SANRA for narrative reviews).
Results
The search identified 16,675 records, of which 125 reviews met inclusion criteria after screening. The included reviews covered three key domains of ADHD-related impacts:
Mental Health (42 reviews):
Physical Health (51 reviews):
Social and Lifestyle (32 reviews):
Insight
This comprehensive umbrella review provides a broad overview of the wide-ranging impacts associated with ADHD beyond its core symptomatology.
The findings underscore that ADHD is not merely a disorder of attention and hyperactivity/impulsivity, but one that can profoundly affect multiple domains of an individual’s life across the lifespan.
The strong associations found between ADHD and various mental health conditions, particularly addictions and mood disorders, highlight the need for careful assessment and management of comorbidities in ADHD care.
The bidirectional relationships observed between ADHD and some conditions (e.g., sleep disorders) suggest complex interactions that require further investigation.
In the realm of physical health, the consistent links between ADHD and obesity, sleep problems, and accidental injuries point to the importance of addressing lifestyle factors and safety concerns in ADHD management.
The associations with various other health conditions also indicate a need for interdisciplinary approaches to ADHD care involving mental health professionals, primary care providers, and relevant specialists.
The social and lifestyle impacts identified, including academic/occupational difficulties, relationship problems, and increased risk-taking behaviors, emphasize the far-reaching effects of ADHD on daily functioning and quality of life.
These findings underscore the importance of providing comprehensive support for individuals with ADHD that addresses not just core symptoms, but also aims to improve overall life outcomes.
It highlights the interconnected nature of many ADHD-associated impacts and the potential for cascading effects across different areas of functioning.
Future research should focus on:
Strengths
The study had several methodological strengths, including:
Limitations
Despite its strengths, this umbrella review has several limitations:
These limitations may affect the generalizability and comprehensiveness of the findings. The variability in review quality highlights the need for caution in interpreting results, particularly from lower-quality reviews.
The potential for publication bias and focus on negative outcomes may lead to an overestimation of adverse impacts associated with ADHD.
Implications
The findings of this umbrella review have significant implications for clinical practice, policy, and future research related to ADHD:
By addressing the multi-faceted impacts of ADHD, interventions may be able to more effectively improve overall quality of life and long-term outcomes for affected individuals.
References
Primary reference
French, B., Nalbant, G., Wright, H., Sayal, K., Daley, D., Groom, M. J., Cassidy, S., & Hall, C. L. (2024). The impacts associated with having ADHD: an umbrella review.Frontiers in psychiatry,15, 1343314.https://doi.org/10.3389/fpsyt.2024.1343314
Other references
Harpin, V. A. (2005). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life.Archives of disease in childhood,90(suppl 1), i2-i7.
Nigg, J. T. (2013). Attention-deficit/hyperactivity disorder and adverse health outcomes.Clinical psychology review,33(2), 215-228.https://doi.org/10.1016/j.cpr.2012.11.005
Polanczyk, G., De Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis.American journal of psychiatry,164(6), 942-948.https://doi.org/10.1176/ajp.2007.164.6.942
Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment.BMC medicine,10, 1-15.https://doi.org/10.1186/1741-7015-10-99
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
