O'Nions Elizabeth, El Baou Céline, John Amber, Lewer Dan, Mandy Will, McKechnie Douglas G J, Petersen Irene, Stott Josh
UCL Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, London, UK.
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Br J Psychiatry. 2025 Jan 23:1-8. doi: 10.1192/bjp.2024.199.
Nearly 3% of adults have attention-deficit and hyperactivity disorder (ADHD), although in the UK, most are undiagnosed. Adults with ADHD on average experience poorer educational and employment outcomes, worse physical and mental health and are more likely to die prematurely. No studies have yet used mortality data to examine the life expectancy deficit experienced by adults with diagnosed ADHD in the UK or worldwide.
This study used the life-table method to calculate the life-expectancy deficit for people with diagnosed ADHD using data from UK primary care.
A matched cohort study using prospectively collected primary care data (792 general practices, 9 561 450 people contributing eligible person-time from 2000-2019). We identified 30 039 people aged 18+ with diagnosed ADHD, plus a comparison group of 300 390 participants matched (1:10) by age, sex and primary care practice. We used Poisson regression to estimate age-specific mortality rates, and life tables to estimate life expectancy for people aged 18+ with diagnosed ADHD.
Around 0.32% of adults in the cohort had an ADHD diagnosis, ~1 in 9 of all adults with ADHD. Diagnoses of common physical and mental health conditions were more common in adults with diagnosed ADHD than the comparison group. The apparent reduction in life expectancy for adults with diagnosed ADHD relative to the general population was 6.78 years (95% CI: 4.50 to 9.11) for males, and 8.64 years (95% CI: 6.55 to 10.91) for females.
Adults with diagnosed ADHD are living shorter lives than they should. We believe that this is likely caused by modifiable risk factors and unmet support and treatment needs in terms of both ADHD and co-occurring mental and physical health conditions. This study included data from adults with diagnosed ADHD; the results may not generalise to the entire population of adults with ADHD, the vast majority of whom are undiagnosed.
近3%的成年人患有注意力缺陷多动障碍（ADHD），尽管在英国，大多数患者未被诊断出来。患有ADHD的成年人平均在教育和就业方面的成果较差，身心健康状况也更糟，且过早死亡的可能性更高。尚无研究利用死亡率数据来考察在英国或全球范围内被诊断患有ADHD的成年人的预期寿命赤字情况。
本研究采用生命表法，利用英国初级保健数据计算被诊断患有ADHD的人群的预期寿命赤字。
一项匹配队列研究，使用前瞻性收集的初级保健数据（792家全科诊所，2000年至2019年期间9561450人贡献了符合条件的人时）。我们识别出30039名18岁及以上被诊断患有ADHD的人，以及一个由300390名参与者组成的对照组，该对照组按年龄、性别和初级保健诊所进行1:10匹配。我们使用泊松回归来估计特定年龄的死亡率，并使用生命表来估计18岁及以上被诊断患有ADHD的人的预期寿命。
队列中约0.32%的成年人被诊断患有ADHD，占所有ADHD成年人的约九分之一。与对照组相比，被诊断患有ADHD的成年人中常见的身心健康状况诊断更为普遍。被诊断患有ADHD的成年男性相对于普通人群的预期寿命明显缩短6.78岁（95%置信区间：4.50至9.11），成年女性则缩短8.64岁（95%置信区间：6.55至10.91）。
被诊断患有ADHD的成年人寿命比预期的短。我们认为，这可能是由可改变的风险因素以及在ADHD以及同时存在的身心健康状况方面未得到满足的支持和治疗需求导致的。本研究纳入了被诊断患有ADHD的成年人的数据；结果可能不适用于所有患有ADHD的成年人，其中绝大多数未被诊断。
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