A study of more than 30,000 British adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) found that they died earlier on average than the general population – men They die about seven years earlier, while women die about nine years earlier.
The study, published Thursday in the British Journal of Psychiatry, is believed to be the first to use all-cause mortality data to estimate life expectancy for people with ADHD. Previous research has pointed to a range of risks associated with this condition. These include poverty, mental health disorders, smoking, and substance abuse.
The authors cautioned that ADHD is significantly underdiagnosed and that the people studied, most of whom were diagnosed as young adults, may be more severely affected. Still, they called the findings “very worrying” and highlighted unmet needs that “require urgent attention.”
“These are large numbers and alarming,” said Joshua Stott, professor of aging and clinical psychology at University College London and author of the study. “I see it as more likely to be about health inequalities than anything else. But this is a pretty large health disparity.”
Although the study did not determine the cause of early death in people with ADHD, they were twice as likely to smoke or abuse alcohol as the general population, and had higher rates of autism, self-harm, and personality disorders. It was found to be much higher than the general population. population. As adults, Dr. Stott says, “we have more difficulty controlling our impulses and are more likely to engage in risky behaviors.”
He said the health care system may need to adjust to better serve patients with ADHD, who may have sensory sensitivities and difficulty managing time and communicating with clinicians during short visits. He said no. He said he hopes treatments for substance abuse and depression will be extended to patients with ADHD.
“When it comes to systems, we’re malleable,” he said. “There's no need for that.”
Previous studies have pointed to a disproportionate number of early deaths in people with ADHD. A 2022 meta-analysis published in JAMA Pediatrics found that the mortality rate from unnatural causes, such as accidents and suicide, was 2.81 times higher than the mortality rate for patients diagnosed with ADHD. ordinary people.
A 2019 study that used actuarial tables to predict life expectancy concluded that adults diagnosed with ADHD in childhood had a life expectancy 8.4 years less than the general population, the authors said. This is attributed to a decrease in education and income, an increase in smoking rates and alcohol consumption, and a decrease in sleep.
Russell Barclay, lead author of the study, said the data showed that ADHD should be seen as a lifelong problem, rather than a childhood disorder like bedwetting.
“For me, the closest analogy is diabetes,” said Dr. Barclay, a former professor of clinical psychology at Virginia Commonwealth University. “It's a disease that has to be managed, just like high blood pressure, cholesterol, diabetes. It's a lifelong disease that you have to treat.”
The new study looked at 9,561,450 patients in primary care in the UK National Health Service, of whom 30,039 were diagnosed with ADHD. Each person in the ADHD group was matched with 10 peers without the disorder for comparison purposes. Among patients with ADHD, 193 male and 148 female patients died during the follow-up period, which lasted from 2000 to 2019.
Stephen Hinshaw, a psychology professor at the University of California, Berkeley, who studies ADHD but was not involved in the new British study, said the study is the first analysis of deaths in subjects diagnosed with the disorder. He said it was a “significant discovery.” He said it was unfortunate that the subjects' causes of death were not included.
“There are risk factors that need to be addressed,” he said. “That's an important limitation of this study, because from a prevention perspective, it's really important to know whether we should focus on suicide or not.” Is diet and exercise better? depression? “
Diagnosis of ADHD has changed in recent years, with clinicians concluding that many older adults, especially women and people of color, go undiagnosed early in life and may benefit from treatment. I'm wearing it. While primary diagnoses are rapidly increasing among older adults, prevalence in children has remained consistent, at approximately 11% in the United States and 5% in the United Kingdom.
Dr. Stott said she expects health systems to do more to identify the needs of neurodiverse patients as these demographic changes take hold. Over the past few decades, they may have been viewed disparagingly by parents as “the naughty kids at school,” he said.
“When you're a kid and you're always told, 'Sit down, stop messing around,' and if you talk to people with ADHD, and that's their experience, stop talking, go out and sit down. Please,” he says. “All of these things hurt your life chances in many ways.”
