People with ADHD face higher mortality rates, but taking medication may mitigate this risk, finds a study led by University of Liverpool and UCL researchers.
For the study, published in JAMA Network Open, the researchers conducted a systematic review and meta-analysis of 19 studies that included data from close to 16 million study participants on three continents.
In a meta-analysis of observational studies, they found that ADHD is linked to higher rates of suicide and injury deaths, as well as a moderate increase in natural-cause mortality. But they found some evidence that this mortality risk is lower among people who take ADHD medication.
Senior author Professor Joshua Stott, UCL Psychology and Language Sciences said: "We found that people with ADHD face an increased risk not only of death by suicide and injury, but also of deaths by natural causes, adding to evidence that health inequalities faced by people with ADHD are broad and wide-ranging.
"ADHD is not by definition a life-limiting condition as the right support and treatment can help people with ADHD to live long and healthy lives. Our findings underscore the importance of ensuring that everyone who may have ADHD has access to accurate diagnosis and treatment."
The researchers reviewed evidence from 19 studies that tracked large numbers of people with and without ADHD for multiple years, in some cases following up study participants for over 20 years, in order to compare mortality rates between groups.
They found that people with an ADHD diagnosis had a 70% higher rate of death from any cause than people without an ADHD diagnosis. The rate of death by suicide was 90% higher among people with ADHD, and the rate of death from injuries, whether intentional or accidental, was 55% higher. The rate of death from natural causes was 27% higher.
The researchers point to evidence that people with ADHD are more likely to experience mental health problems and face challenges with emotional regulation, impulse control and risk-taking. They also experience more societal exclusion, disadvantage, and stigma. Unintentional injury deaths, such as road deaths, may also be linked to differences in attention.
In previous research, the authors found that people with ADHD experience higher rates of physical health conditions such as cardiovascular disease, metabolic disorders, diabetes or cancer. Mortality from natural causes may be linked to health risk behaviours such as smoking or alcohol use. People with ADHD may also experience challenges with engagement and access to health care, and with adherence to medical treatment.
Among people with ADHD, those who take ADHD medication appeared to have a 25% lower mortality risk, although the researchers caution that this finding was only based on three of the 19 included studies.
First author Lucy Corrigan, Psychology, University of Liverpool said: "Our findings provide early evidence to suggest that medication may play an important role in supporting the health of people with ADHD, but this is based on a small number of studies and further research is needed to clarify this link. And medication is just part of the story; many people with ADHD benefit from comprehensive, long-term treatment and support."
Senior author Dr Amber John, Psychology Lecturer, University of Liverpool said: "Many people with ADHD face challenges throughout their lives, so equitable access to evidence-based assessment and treatment is vital to ensure they can live long, healthy lives."
