ADHD linked to higher mortality risk, but medication may help reduce deaths

A systematic review of nearly 16 million people published in JAMA Network Open shows that ADHD is linked to a 70% to 71% higher rate of all-cause mortality, driven by a 90% increase in suicide, a 55% increase in injury deaths, and a 27% rise in natural-cause mortality. While preliminary findings suggest ADHD medication corresponds with a 25% lower overall mortality risk, researchers caution the observational data cannot prove causality, underscoring critical gaps in timely diagnosis and treatment access.

Overall mortality risk in ADHD

• ▪A JAMA Network Open systematic review and meta-analysis led by University College London researchers found that attention-deficit/hyperactivity disorder is associated with a 70% to 71% higher rate of all-cause mortality.
• ▪The JAMA Network Open systematic review and meta-analysis evaluated 19 observational studies encompassing nearly 16 million study participants across three continents, with 63.9% of participants being male.

Suicide risk and contributing factors

• ▪The JAMA Network Open study found that people diagnosed with attention-deficit/hyperactivity disorder face a 89% to 90% higher rate of death by suicide compared to individuals without ADHD.
• ▪Researchers observed that co-existing mental health conditions like depression, along with emotional regulation and impulse control challenges, may contribute to elevated suicide rates among people with ADHD.

Injury mortality and behavioral links

• ▪The JAMA Network Open meta-analysis showed that individuals with attention-deficit/hyperactivity disorder experience a 55% higher rate of death from intentional or accidental injuries than those without ADHD.
• ▪Unintentional injury deaths among individuals with ADHD, such as road traffic accidents, are linked to differences in attention, risk-taking behaviors, and impulsivity.

Natural-cause mortality and contributing factors

• ▪The meta-analysis revealed a 27% increase in natural-cause mortality risk among individuals diagnosed with attention-deficit/hyperactivity disorder compared to those without the condition.
• ▪Natural-cause mortality in ADHD patients is linked to higher rates of cardiovascular disease, diabetes, metabolic disorders, health risk behaviors like smoking and alcohol use, and healthcare access barriers.

Impact of ADHD medication on mortality

• ▪An analysis of three studies within the JAMA Network Open review found that individuals taking ADHD medication had a 25% lower risk of all-cause mortality compared to untreated individuals.
• ▪Researchers warned that the apparent 25% mortality reduction associated with ADHD medication is based on only three observational studies, preventing causal conclusions and requiring caution due to potential confounding factors.

ADHD diagnosis rates and prevalence

• ▪Senior author Professor Joshua Stott noted that while ADHD diagnosis rates have risen in recent years, they continue to lag behind actual prevalence, particularly among older age groups facing higher mortality risk.
• ▪CDC estimates show that 15 million U.S. adults (6%) and 7 million U.S. children (11.7%) have ADHD, with Mount Sinai's Dr. Jeffrey Newcorn noting that up to half of adult diagnoses occur in adulthood.