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A systematic review and meta-analysis covering nearly 16 million people found ADHD was associated with higher all-cause mortality and higher risks of suicide, injury and natural-cause death. ADHD medication use was associated with lower all-cause mortality, but that result came from only three studies and cannot establish that medication caused the difference.
A systematic review and meta-analysis covering nearly 16 million people found that people with attention-deficit/hyperactivity disorder (ADHD) had a 71% higher relative risk of death from any cause than people without ADHD, according to research published in JAMA Network Open. The study also found higher relative risks of suicide, injury and natural-cause mortality, while an association between ADHD medication and lower mortality was based on just three studies.
Joshua Stott, PhD, of University College London, and colleagues analyzed 19 studies with a total of 15,920,970 participants. Twelve studies contributed data to five meta-analyses. The researchers reported an all-cause mortality hazard ratio of 1.71 for ADHD (95% confidence interval 1.31 to 2.24). A hazard ratio compares the rate at which an outcome occurs between groups over time; it does not mean that 71% of people with ADHD will die.
The review also found elevated relative risks for suicide (hazard ratio 1.89), intentional or unintentional injury (1.55), and natural-cause mortality (1.27). The authors said the association with natural-cause deaths could involve factors such as smoking, alcohol use, barriers to health care and higher rates of cardiovascular and metabolic conditions. These are possible pathways discussed by the researchers, not causes established by the meta-analysis.
In a separate analysis, ADHD medication use was associated with a 25% lower relative risk of all-cause mortality (hazard ratio 0.75; 95% confidence interval 0.64 to 0.87). That analysis included only three studies. The researchers cautioned that differences between treated and untreated people—including health care access, illness severity, socioeconomic circumstances and other mental health conditions—could influence the result.
Mortality Risk and ADHD Care
The findings add a large body of evidence to concern about health and safety risks among people with ADHD, including risks that extend beyond injury and suicide. The results may support attention to timely assessment and ongoing care, particularly where ADHD remains unrecognized. They do not establish that ADHD itself directly causes early death, or that treating ADHD will prevent deaths.
Stott told MedPage Today that the findings do not mean everyone with ADHD will die young or that higher mortality is inherent or unchangeable. He said they underscore the importance of access to accurate diagnosis and treatment. The medication result should not be interpreted as proof of a protective effect: observational associations can reflect differences in who receives care as well as treatment itself.
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How Researchers Combined the Evidence
The research team searched for quantitative studies reporting all-cause or cause-specific mortality in people with ADHD, including research across age groups. The review included peer-reviewed studies available through July 2025. ADHD was identified in the source studies through diagnostic criteria, self-identification, measures of ADHD traits or genetic risk scores.
The included studies varied across populations and methods. The authors reported substantial statistical heterogeneity in the analyses of all-cause mortality, suicide and injury, meaning estimates differed across studies. They said, however, that the studies consistently showed higher mortality in ADHD groups, suggesting differences in the size of the association rather than its direction. The total sample was 63.9% male, and the researchers noted gender imbalances and cross-cultural differences in diagnostic criteria and access to care.
Jeffrey Newcorn, MD, of the Icahn School of Medicine at Mount Sinai, who was not involved in the study, told MedPage Today that adult ADHD is often diagnosed late and that many adults diagnosed with the condition do not receive treatment. He also noted that ADHD typically begins in childhood, even when it is identified in adulthood.
“These findings do not suggest that everyone with ADHD will die young, nor do they suggest that increased mortality is impossible to change or inherent to ADHD.”
— Joshua Stott, PhD, University College London, speaking to MedPage Today
Limits of the Mortality Estimates
The review establishes associations, not cause and effect. Its pooled estimates draw on studies that differed in population, ADHD definitions and methods; substantial heterogeneity in several analyses limits how precisely one overall figure describes every group. The findings also do not specify an individual’s absolute chance of death or a single mechanism behind the increased risks.
The lower mortality associated with medication is particularly uncertain because it rests on three studies and may be affected by confounding, including differences in health status, treatment access and adherence. The available material does not establish which medications, treatment durations or patient groups account for the association, nor whether medication itself changes mortality risk.
Questions for Future ADHD Research
The review reports results from studies available through July 2025; it does not announce a new clinical trial or a change to treatment guidance. Further research would need to clarify how mortality associations vary by age, sex, cause of death and access to care, and to examine whether the medication association remains after accounting for differences between treated and untreated patients.
For now, the authors’ stated implication is to improve access to accurate ADHD diagnosis and treatment. The study does not tell individuals to start, stop or change medication. Treatment decisions remain matters for patients and their health care professionals.
Key Questions
Does the study show that ADHD causes early death?
No. The review found that ADHD was associated with higher mortality across the included studies. It cannot show that ADHD itself caused the deaths or identify one explanation for the association.What does a 71% higher mortality risk mean?
It refers to a relative hazard ratio of 1.71 for all-cause mortality in the pooled analysis. It does not mean that 71% of people with ADHD die, and it does not give an individual’s absolute risk.Did ADHD medication lower mortality?
Medication use was associated with a lower all-cause mortality risk in an analysis of three studies. The researchers cautioned that differences between people who did and did not receive medication could explain some or all of that association.Which causes of death were associated with ADHD?
The review reported higher relative risks for suicide, intentional or unintentional injury, and natural-cause mortality, as well as higher all-cause mortality.What should readers do with these findings?
The study supports attention to access to accurate assessment and care, but it is not individualized medical advice. People should discuss ADHD diagnosis or treatment questions with a qualified health care professional.Source: rss
