Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Hochschule Niederrhein, University of Applied Sciences, Krefeld, Germany.
Acta Psychiatr Scand. 2023 Feb;147(2):145-154. doi: 10.1111/acps.13524. Epub 2022 Dec 14.
Attention deficit hyperactivity disorder (ADHD) is associated with risk-taking behavior, leading to accidents and unintentional injuries (summarized here as incidents). Main aim of this study is to determine if men and women with and without ADHD differ in the risk of mild (treated outpatient) and severe (treated inpatient) incidents across the adult lifespan (age groups: 18-29; 30-59, and ≥60 years). Secondary aim: investigate the role of comorbid mental disorders and drugs for the treatment of these comorbidities, and ADHD-medication.
Using anonymized German claims data (N = 4,575,027), adults with ADHD diagnosis during 2016-2019 (N = 17,041) were compared with a 1:4 age and sex-matched group without ADHD diagnosis. Regression analyses statistically tested group differences.
Incidents occur in a U-shaped form across the adult lifespan. Individuals with ADHD show the same pattern but at a substantially increased risk of both mild and severe incidents throughout the lifespan. Women without ADHD are at lower risk in young adulthood than men but at higher risk in older adulthood. Women with ADHD show the same pattern for severe incidents, but for mild incidents they have the highest risk throughout the lifespan. Co-occurring anxiety disorder and the use of psycholeptics and ADHD-medication decreased the incident risk.
We extend available knowledge which has hitherto focused on young adult males and traffic accidents. ADHD is associated with increased incidents across the adult lifespan, with distinct patterns regarding age, sex, and incident severity. An accurate diagnosis of ADHD in adulthood provides the first step towards prevention of accidents and unintentional injuries.
注意缺陷多动障碍（ADHD）与冒险行为有关，导致事故和意外伤害（这里总结为事件）。本研究的主要目的是确定患有和不患有 ADHD 的男性和女性在整个成年期（年龄组：18-29 岁；30-59 岁，和≥60 岁）中轻度（门诊治疗）和重度（住院治疗）事件的风险是否存在差异。次要目的：研究共患精神障碍和治疗这些共病的药物（如精神药物）的作用。
使用匿名德国索赔数据（N=4,575,027），在 2016-2019 年期间患有 ADHD 诊断的成年人（N=17,041）与没有 ADHD 诊断的年龄和性别匹配的 1:4 组进行比较。回归分析统计测试了组间差异。
事件在成年期呈 U 形发生。患有 ADHD 的个体也呈现出相同的模式，但在整个生命周期中，轻度和重度事件的风险都大大增加。没有 ADHD 的女性在年轻成年期的风险低于男性，但在老年成年期的风险较高。没有 ADHD 的女性在重度事件中呈现出相同的模式，但在轻度事件中，她们在整个生命周期中风险最高。共患焦虑障碍和使用精神药物和 ADHD 药物可降低事件风险。
我们扩展了现有知识，这些知识迄今为止主要集中在年轻成年男性和交通事故上。ADHD 与整个成年期的事件增加有关，与年龄、性别和事件严重程度有关的特定模式。在成年期准确诊断 ADHD 是预防事故和意外伤害的第一步。
