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ADHD is a neurodevelopmental condition that can cause difficulty concentrating and focusing, hyperactivity, and impulsiveness. ADHD itself was not likely to be the reason for the gap in life expectancy, the researchers said – highlighting that people with ADHD were more likely to experience reduced sleep, have greater alcohol consumption, smoke, experience inequality, or have unmet mental and physical health conditions.
“The evidence that people with diagnosed ADHD are living shorter lives than they should is extremely concerning, and highlights unmet support needs that require urgent attention,” the study said.
Josh Stott, one of the study’s authors and a professor of aging and clinical psychology at University College London, said in a telephone interview Friday that the researchers did not have data for the causes of death but that a number of factors could have been at play.
“People with ADHD, we know from the literature, are more likely to take risks and live with difficulties with impulsivity, which means that they may also be more likely to develop addictive behaviours like smoking, drinking and perhaps eating more than they should,” he said. “So, all of those things are kind of associated with health risks later.”
People with ADHD also have higher rates of mental health issues and even suicide rates, which could also have an impact.
“So, if you think about it from school, I think certainly when a lot of these people were younger in particular, there was much less recognition,” Stott said, “and people would have been labeled naughty and that would have cumulatively affected their life chances, probably.”
The report noted that while almost 3 percent of adults are believed to have the disorder, only a small percentage of adults with ADHD in the United Kingdom have been diagnosed.
“More of those who are diagnosed may have additional health problems compared to the average person with ADHD,” Liz O’Nions, the lead author of the study, said in a news release Thursday. “Therefore, our research may over-estimate the life expectancy gap for people with ADHD overall, though more community-based research is needed to test whether this is the case.”
In the United States, doctors have reported growing numbers of ADHD diagnoses in recent years – although, as the authors of one study said in 2018, this may be the result of better understanding of the condition rather than overdiagnosis.
An estimated 11 percent of American children have received a diagnosis of ADHD, according to the Centers for Disease Control and Prevention; those who had another co-occurring condition, such as behavioural or conduct problems, learning disorders, anxiety, or depression, tended to have more severe ADHD than other children who were diagnosed.
Oliver Howes, a professor of molecular psychiatry at King’s College London, who was not involved in the study, wrote that the findings showed “the massive impact of ADHD on people’s lives.”
“The study is also striking in showing how few people with ADHD get a diagnosis,” he said. “These findings highlight the need for much more investment in mental health services so people can get the help they need.”
Similarly, the report authors noted that helping adults with ADHD to access work and preventing discrimination could help to reduce the disparity in life expectancy.
The study did not account for whether patients diagnosed with ADHD were receiving medical treatment for their symptoms, which Stott said was due to a lack of good data. However, research published last year that followed almost 150,000 children and adults in Sweden found that the use of medication to treat ADHD reduced the risk of premature death from unnatural causes, such as accidents and overdoses, by a quarter.
The researchers in Thursday’s report noted that race and ethnicity may also be a factor and that U.S. data had indicated disparities in the diagnosis or treatment of ADHD – although the lack of usable data on this meant that they did not include this information in the study.
The study also did not adjust for socioeconomic status. Stott explained this was because “it’s part of the picture if you have ADHD,” noting that people with the condition are “more likely to fall into a low socioeconomic status. So, we didn’t want to iron out that difference because actually it’s part of having ADHD.”
A further limitation, the researchers wrote, is that the findings may not apply to other countries, time periods or settings.
Stott, nonetheless, noted that while his study is based on a small percentage of the British population, other studies had also shown a greater mortality risk for people with ADHD. He and the other report authors believe their study is the first to use mortality data to work out the impact on life expectancy and present a quantifiable number of years of life lost.
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