People who suffer from attention-deficit/hyperactivity disorder (ADHD) are more than twice as likely as those without the condition to die prematurely, with proneness to accidents a key factor.
Søren Dalsgaard, MD, PhD, of Aarhus University, Aarhus, Denmark, and colleagues conducted a large cohort study that included almost two million Danish people, including more than 32,000 individuals with ADHD, from the age of one until 2013 (up to a maximum of 32 years).
People diagnosed with ADHD were nearly twice as likely to die prematurely as those without the disorder, even accounting for factors known to influence the risk for early death, such as age, sex, family history of psychiatric illness, maternal and paternal age, and parental education, the researchers reported in The Lancet.
The higher risk of premature death was primarily the result of unnatural causes, according to the researchers. Of the 79 people with ADHD in the study who had died and whose cause of death was known, 42 — more than half — were the result of an accident.
In addition, a risk of dying early correlated with the age at which the ADHD diagnosis was made. For example, those diagnosed with ADHD at age 18 or older were more than four times as likely to die prematurely compared with those without the condition. But children diagnosed before they turned six were only about twice as likely to have an early death compared with health peers.
Also, girls and women with ADHD have a higher relative risk of premature death compared with boys and men.
“Our findings emphasise the importance diagnosing ADHD early, especially in girls and women, and treating any co-existing antisocial and substance-use disorders,” Dalsgaard said in a statement. “It is however important to emphasise that although the relative risk of premature death is increased in ADHD, the absolute risk is low.”
In an associated comment to the study, Stephen Faraone, PhD, Director of Child and Adolescent Psychiatry Research at SUNY Upstate Medical University in New York, wrote, “For too long, the validity of ADHD as a medical disorder has been challenged. Policy makers should take heed of these data and allocate a fair share of health care and research resources to people with ADHD. For clinicians, early identification and treatment should become the rule rather than the exception.”
Dalsgaard S, et al. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015; http://dx.doi.org/10.1016/S0140-6736(14)61684-6.