ADHD May Increase Risk of Premature Death

Attention-deficit/hyperactivity disorder (ADHD) is associated with an elevated risk of premature death, according to a study published online in JAMA Psychiatry.

Shihua Sun, M.D., from the Karolinska Institutet in Stockholm, and colleagues used Swedish national registers to identify 2,675,615 individuals born in Sweden (1983 to 2009), including 86,670 individuals (3.2 percent) who received a diagnosis of ADHD during follow-up through 2013.

The researchers found that during follow-up, 424 individuals with ADHD and 6,231 without ADHD died (mortality rates of 11.57 and 2.16 per 10,000 person-years, respectively). The association was stronger for death in adulthood (hazard ratio [HR], 4.64; 95 percent confidence interval [CI], 4.11 to 5.25) versus childhood (HR, 1.41; 95 percent CI, 0.97 to 2.04). The risk of death also increased substantially with the number of psychiatric comorbidities with ADHD (HR for individuals with only ADHD: 1.41 [95 percent CI, 1.01 to 1.97]; HR for individuals with at least four comorbidities: 25.22 [95 percent CI, 19.60 to 32.46]). However, for deaths in adulthood, when adjusting for early-onset psychiatric comorbidity, the association between ADHD and risk of death due to natural causes was no longer statistically significant (HR, 1.32; 95 percent CI, 0.94 to 1.85).

"These findings suggest that health care professionals should closely monitor specific psychiatric comorbidities in individuals with ADHD to identify high-risk groups and implement prevention efforts," the authors write.

Authors disclosed financial ties to the pharmaceutical industry.

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