ADHD linked to higher death rates in meta-analysis of 16 million people; medication use associated with lower risk

People with ADHD have higher death rates than people without the diagnosis, but the excess risk may be lower among those who take ADHD medication, according to a systematic review and meta-analysis led by UCL and the University of Liverpool and published in JAMA Network Open.

The study

• The team pooled 19 observational studies with data from close to 16 million participants on three continents; some followed people for more than 20 years.
• People diagnosed with ADHD had a 70% higher rate of death from any cause.
• Death by suicide was 90% higher, deaths from injuries (intentional or accidental) 55% higher, and deaths from natural causes 27% higher.
• The researchers found some evidence that the mortality risk was lower among people taking ADHD medication.

Possible explanations

The authors point to evidence that people with ADHD are more likely to experience mental health problems and difficulties with emotional regulation, impulse control and risk-taking, and also face more social exclusion, disadvantage and stigma. Differences in attention may contribute to accidental deaths such as road deaths.

Limitations

All included studies were observational, so the review cannot show that ADHD or medication causes the differences. The studies varied widely in how large an effect they found, and the medication findings rest on a small number of studies, so the authors urge particular caution. Anyone with questions about ADHD or its treatment should talk to their doctor.