According to a large, register-based study by Karolinska Institutet in Sweden, adults with ADHD are more likely to develop a variety of physical conditions including neurological, respiratory, musculoskeletal and metabolic disorders. The Lancet Psychiatry.
Ebba du Rietz, a postdoctoral researcher at Karolinska Institutet’s Department of Medical Epidemiology and Biostatistics, said that “identifying co-occurring medical diseases may have important implications to treat adults with ADHD and benefit the long-term quality of health and life of patients.”
ADHD is a common neuropsychiatric disorder characterized by inattention and impulsiveness. It is often treated with stimulant therapy (methylphenidates, amphetamines).
Although there have been some studies that suggest an increased risk of a variety of physical conditions in adults with ADHD, only a few of these associations have been fully researched. Unfortunately, there are not many treatment guidelines for ADHD adults and co-occurring diseases. Researchers at Karolinska Institutet now examine possible associations between ADHD, a wide range physical diseases, and whether environmental or genetic factors are involved.
The Swedish registers identified over four million individuals (full sibling and maternal half siblings) who were born between 1932-1995. These individuals were followed between 1973 and 2013. The Swedish National Patient Register gave the clinical diagnoses. Researchers compared the risk of 35 conditions in people with ADHD to those without it, as well as in siblings of people with ADHD to siblings without it.
ADHD individuals had a statistically significant increase in the risk of all other conditions, except arthritis. The strongest associations were found to be with metabolic, nervous system, respiratory and musculoskeletal diseases. ADHD is strongly associated with alcohol-related liver disease, sleep disorders and chronic obstructive lung disease (COPD), epilepsy and fatty liver disease. ADHD was also associated to an increased risk of developing Parkinson’s disease, cardiovascular disease, and dementia.
“These results are important because stimulant therapy requires careful monitoring in ADHD patients with co-occurring cardiac disease, hypertension and liver failure,” says senior author Henrik Larsson, professor at Örebro University and affiliated researcher at Karolinska Institutet.
The increased risk was largely explained mainly by underlying genetic factors. ADHD affected full siblings had a significantly higher risk of developing most physical conditions.
Researchers now plan to investigate the underlying mechanisms and risk factors of ADHD, as well as the impact of ADHD management and prognosis on physical diseases in adults.
The Swedish Research Council, The Swedish Brain Foundation, The Swedish Research Council for Health, Working Life and Welfare, Region Stockholm, StratNeuro, The Karolinska Institutet, The National Institute of Mental Health, and The European Union’s Horizon 2020 research and innovative programme. Ebba Du Retz has been a speaker for Shire Sweden AB, outside of the submitted work. Henrik Larsson has been a speaker for Evolan Pharma, Shire/Takeda, and has received research grants by Shire/Takeda. Co-author Marica Leone is an employee of Janssen Pharmaceutical Companies of Johnson & Johnson. For a complete list, see the scientific article.
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