Sustainable labour market participation among working young adults with diagnosed attention deficit/hyperactivity disorder (ADHD)

Magnus Helgesson; Linnea Kjeldgård; Emma Björkenstam; Syed Rahman; Klas Gustafsson; Heidi Taipale; Antti Tanskanen; Lisa Ekselius; Ellenor Mittendorfer-Rutz

doi:10.1016/j.ssmph.2023.101444

Sustainable labour market participation among working young adults with diagnosed attention deficit/hyperactivity disorder (ADHD)

SSM Popul Health. 2023 Jun 12:23:101444. doi: 10.1016/j.ssmph.2023.101444. eCollection 2023 Sep.

Authors

Magnus Helgesson^{1

2}, Linnea Kjeldgård¹, Emma Björkenstam^{1

3}, Syed Rahman¹, Klas Gustafsson¹, Heidi Taipale^{1

4

5}, Antti Tanskanen^{1

4}, Lisa Ekselius⁶, Ellenor Mittendorfer-Rutz¹

Affiliations

¹ Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden.
² Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-752 37, Uppsala, Sweden.
³ Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.
⁴ Niuvanniemi Hospital, Kuopio, Finland.
⁵ School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
⁶ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Abstract

Background: The aims were to study the sustainability of labour-market participation five years after an incident diagnosis of attention-deficit/hyperactivity disorder (ADHD) among young adults with gainful employment, and to examine the impact of sociodemographic-, work- and health-related factors on these findings.

Methods: Swedish registers identified 2517 individuals, 19-29 years old, with an incident diagnosis of ADHD and gainful employment during 2006-2011. Labour-market participation was measured by the core-peripheral model, a model that measures the connection to the labour market from a weak connection (peripheral) to a strong connection (core). Sequence analysis analysed clusters of labour-market participation, from one year before and up to five years after diagnosis. Odds ratios (OR) with 95% confidence intervals (CI) between sociodemographic factors, comorbid disorders, and the identified clusters were analysed by multinomial logistic regression.

Results: Five clusters of labour-market participation were identified: 60% of individuals belonged to a cluster that maintained labour-market participation throughout the study period (core, close to core); 20% belonged to a cluster with a transition to a weak connection to the labour market (close to peripheral, peripheral); and 20% belonged to a cluster with "middle" labour-market participation, characterised by having long periods of sick leave and unemployment. Individuals with elementary school as highest attained education (OR:4.03;CI:2.35-6.93), comorbid mental disorders (OR:2.77;CI:2.10-3.66), or living in villages/small cities (OR:1.77;CI:1.25-2.51) were most likely to belong to a cluster transitioning towards a "peripheral" labour-market participation. Men were less likely to have peripheral labour-market participation than women (OR:0.55;CI:0.40-0.75).

Conclusions: Over half of working individuals with ADHD maintain a strong attachment to the labour market several years after their first diagnosis of ADHD. Therefore, it is important to target those who have problems maintaining a position in the labour market, including women, those with low educational levels, and those living outside large cities.

Keywords: ADHD; Attention-deficit/hyperactivity disorder; Core-peripheral theory; Disability pension; Labour market participation; Sequence analysis; Sick leave; Social welfare.