Patients with ADHD Face Higher Risk of Death, Especially Women and Girls

Individuals with attention deficit hyperactivity disorder (ADHD) have a lower life expectancy and are more than twice as likely to die prematurely compared to healthy patients, according to research published in The Lancet.

Soren Dalsgaard, PhD from Aarhus University in Denmark and colleagues used the Danish national registers to analyze 1.92 million individuals, of which 32,061 had ADHD, from their first birthday through 2013 in order to estimate ADHD related mortality. The researchers noted that ADHD is generally linked to factors likely to increase mortality rates, including oppositional defiant disorder or conduct disorder, criminality, accidents, and substance misuse, though whether ADHD was directly associated with mortality was previously unknown.

The researchers estimated mortality rate ratios (MRRs) and adjusted for calendar year, age, sex, family history of psychiatric disorders, maternal and paternal age, and parental education and employment status. These statistics were compared to individuals included in the study who did not have ADHD.

Over the course of the study, 107 participants with ADHD died. Those patients diagnosed with ADHD were about 2 times more likely to die prematurely as compared to participants without the disorder, even after adjusting for the various demographics the researchers accounted for. Unnatural causes mainly attributed to the increased risk for the premature death of ADHD patients — more than half of the deaths were caused by accidents (42 deaths among 79 people for whom the cause of death was known).

The risk of dying prematurely increased with age at diagnosis, the researchers noted. Patients diagnosed at age 18 years or older were more than 4 times as likely to die early compared to those without ADHD at the same age; however, children diagnosed prior to the age of 6 years old were at around 2 times the increased risk for premature deaths compared to children without the diagnosis. Girls and women with ADHD had a higher relative risk of premature death compared to boys and men with ADHD, the researchers discovered.

“Our findings emphasize the importance diagnosing ADHD early, especially in girls and women, and treating any co existing antisocial and substance use disorders,” Dalsgaard and colleagues wrote in the paper. “It is however important to emphasize that although the relative risk of premature death is increased in ADHD, the absolute risk is low.”