by Francesco D’Amico, Martin Knapp, Jennifer Beecham, Seija Sandberg, Eric Taylor and Kapil Sayal

High levels of early childhood conduct problems are associated with increased health, social care and criminal justice costs in adulthood. There is a two-to-threefold increase in early adulthood costs for children with conduct disorders. These results are particularly important as little is known about the effect of hyperactivity and conduct problems in childhood on service provision or public expenditure. These findings come from a study by researchers from the Personal Social Services Research Unit at LSE and Nottingham University using a 20-year follow-up survey to quantify the impact that behavioural problems in children can have when they reach adulthood. The initial survey took place in the London Borough of Newham and assessed children aged 6-7 years (N=83) with either behavioural problems or from a control group. Behavioural problems included hyperactivity, conduct disorder or the presence of both, and were assessed on the basis of parents’ and teachers’ responses to a questionnaire. The 20-year follow-up study evaluated the same subjects in their late 20s and examined their pattern of health and social care service use and whether they had contacts with criminal justice since age 18.

The results are stable even when taking into account the different backgrounds of the children, for instance whether they lived in deprived housing conditions or their parents had poor employment outcomes.

Being able to quantify the impact that untreated conduct disorders in childhood may have in later life, particularly in terms of problems with criminal justice, could help policy makers in terms of planning preventive strategies. Potential strategies could include increasing awareness among families and teachers about possible indicators of behavioural problems, and also promoting early diagnosis through GPs. Early treatment of behavioural problems in childhood is likely to promote better life outcomes and also reduce future burdens for the criminal justice, health and social care systems.

Full paper

D’Amico F, Knapp M, Beecham J, Sandberg S, Taylor E, Sayal K (2014) Use of services and associated costs for young adults with childhood hyperactivity/conduct problems: 20-year follow-up, British Journal of Psychiatry, published online 27 March 2014.

About the authors 

Francesco D’Amico is Research Officer within the Personal Social Services Research Unit, London School of Economics and Political Science.

Martin Knapp is Director of the Personal Social Services Research Unit and Professor of Social Policy at the London School of Economics and Political Science, and Professor of Health Economics at the Centre for the Economics of Mental and Physical Health, King’s College London, Institute of Psychiatry.

Jennifer Beecham is Professor of Social Policy at the Personal Social Services Research Unit, London School of Economics and Political Science, and Personal Social Services Research Unit, University of Kent.

Seija Sandberg is Senior Lecturer within the Mental Health Sciences Unit at University College London.

Eric Taylor is Professor of Child and Adolescent Psychiatry within the Department of Child and Adolescent Psychiatry at King’s College London, Institute of Psychiatry.

Kapil Sayal is Clinical Associate Professor and Reader in Child and Adolescent Psychiatry within the Division of Psychiatry and Applied Psychology, Institute of Mental Health at the University of Nottingham.