Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden.
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
Psychol Med. 2024 Jan;54(1):148-158. doi: 10.1017/S003329172300096X. Epub 2023 Apr 26.
Multiple Swedish nationwide registers were used to identify 8045 individuals, aged 20-29, with an incident diagnosis of ADHD 2006-2011. Labour market integration was conceptualized according to the core-peripheral model as a continuum from a strong (core) to a weak (peripheral) connection to the labour market. Sequence analyses categorized clusters of labour market integration, from 1 year before to 5 years after their ADHD diagnosis for individuals diagnosed with ADHD and a matched control group without ADHD. Multinomial logistic regression computed odds ratios (ORs) with 95% confidence intervals (CIs) between sociodemographic factors and comorbid disorders and the identified clusters.
About one-fourth of the young adults diagnosed with ADHD belonged to clusters characterized by a transition to a mainly peripheral labour market position, which was approximately four-times higher compared to controls without ADHD. Foremost, those living in small cities/villages (OR 1.9; CI 1.5-2.2), those having comorbid autism-spectrum disorder (OR 13.7; CI 6.8-27.5) or schizophrenia/psychoses (OR 7.8; CI 3.8-15.9) were associated with a transition towards a peripheral labour market position throughout the study period. Those with a high educational level (OR 0.1; CI 0.1-0.1), and men (OR 0.7; CI 0.6-0.8) were less likely to have a peripheral labour market position.
Young adults diagnosed with ADHD are four-times more likely to be in the peripheral labour market position compared to those without ADHD. To increase labour market participation, special attention is warranted to those with low educational level, those living outside big cities and those with comorbid mental disorders.
利用多个瑞典全国性登记处，确定了 8045 名年龄在 20-29 岁之间、2006-2011 年间患有 ADHD 的个体。劳动力市场融合按照核心-外围模型进行概念化，作为从强（核心）到弱（外围）与劳动力市场联系的连续体。序列分析根据 ADHD 诊断前 1 年至诊断后 5 年对 ADHD 患者和无 ADHD 的匹配对照组的劳动力市场融合情况进行分类。使用多项逻辑回归计算了社会人口因素和共病障碍与确定的聚类之间的优势比（OR）及其 95%置信区间（CI）。
大约四分之一被诊断患有 ADHD 的年轻人属于劳动力市场主要向外围过渡的特征聚类，这一比例比没有 ADHD 的对照组高约四倍。首先，居住在小城市/村庄的人（OR 1.9；CI 1.5-2.2）、患有共病自闭症谱系障碍（OR 13.7；CI 6.8-27.5）或精神分裂症/精神病（OR 7.8；CI 3.8-15.9）的人，整个研究期间都与向外围劳动力市场转移有关。具有高教育水平的人（OR 0.1；CI 0.1-0.1）和男性（OR 0.7；CI 0.6-0.8）不太可能处于外围劳动力市场地位。
与无 ADHD 的对照组相比，被诊断患有 ADHD 的年轻人更有可能处于外围劳动力市场地位。为了提高劳动力市场参与率，特别需要关注那些教育水平低、居住在大城市以外的人和患有共病精神障碍的人。
