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

Area of Science:

• Neurodevelopmental Disorders
• Psychiatry
• Public Health

Background:

• Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are prevalent neurodevelopmental conditions.
• Late or undiagnosed ASD/ADHD exacerbates risks including mental health issues, substance misuse, and increased offending.
• This review synthesizes risks associated with undiagnosed ASD/ADHD.

Approach:

• Systematic review of four databases: Medline, Scopus, PsychInfor, and Embase.
• Included published studies on the impact of undiagnosed ASD/ADHD.
• Excluded studies lacking diagnosis status, not solely on ASD/ADHD, gray literature, or non-English publications.
• Findings were synthesized using a narrative approach.

Key Points:

• Seventeen studies were analyzed (14 on ADHD, 3 on ASD).
• Identified themes: Health, Offending Behavior, and Day-to-day Impact.
• Undiagnosed ASD/ADHD linked to poor mental wellbeing, social interaction difficulties, substance abuse, accidents, offending, and lower socioeconomic status.

Conclusions:

• Undiagnosed ASD/ADHD presents significant risks to individuals, families, and society.
• Limited ASD studies necessitate caution in generalizing findings.
• Emphasizes the need for screening and recognition of ASD/ADHD in clinical and forensic settings.