Could ADHD Increase the Risk of Premature Death?

Patients with attention-deficit/hyperactivity disorder (ADHD) had an increased risk for premature death, according to a recent study.

“Attention deficit hyperactivity disorder (ADHD) is a common mental disorder associated with factors that are likely to increase mortality, such as oppositional defiant disorder or conduct disorder, criminality, accidents, and substance misuse,” said the authors of the study.
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“However, whether ADHD itself is associated with increased mortality remains unknown. We aimed to assess ADHD-related mortality in a large cohort of Danish individuals,” they said.

For the study, researchers gathered data from Danish national registers in order to follow 1.9 million participants (32,061 individuals with ADHD) from their first birthday to 2013. 

Mortality rate ratios (MRRs) of patients with ADHD were estimated and adjusted for age, sex, family history of psychiatric disorders, calendar year, maternal and paternal age, parental education, and parental employment status and were then compared to MMRs of participants without ADHD.

During the 24.9 million person-years follow-up, researchers noted that 5580 cohort participants died. Among individuals with ADHD, the mortality rate was 5.85 (per 10,000 person-years), compared to 2.21 in participants without the disorder.

The study showed that accidents were the most common cause of death. Individuals diagnosed with ADHD under 6 years of age had a MRR of 1.86, a 1.58 MRR for those ages 6 to 17 years, and a MMR of 4.25 for individuals 18 years and older, compared to those without ADHD.

The investigators noted that ADHD had the greatest association with increased mortality even after excluding individuals with conduct disorder, substance use, and oppositional defiant disorder.

The increase was higher in girls and women (2.85, 1.56 to 4.71) than in boys and men (1.27, 0.89 to 1.76).

The complete study is published in the February issue of the Lancet.

-Michelle Canales Butcher

Reference:

Dalsgaard S, Otergaard SD, Leckman JF, et al. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015 February [epub ahead of print] doi: http://dx.doi.org/10.1016/S0140-6736(14)61684-6.