Recent Articles of Interest
Mild Mental Illness Associated With Increased Risk Of Premature Death.
BBC News (8/1, Selvadurai) reports, "People with mild mental illnesses, such as anxiety or depression, are more likely to die early," according to a study published online July 31 in the BMJ. For the study, researchers "looked at data over 10 years and matched it to information on death certificates." They found that "low level distress raised the risk by 16%, once lifestyle factors such as drinking and smoking were taken into account," and that "more serious problems increased it by 67%."
The UK's Telegraph (8/1, Adams) reports that people with subclinical anxiety or depression may also be "at a 29 per cent increased risk of dying from 'external causes' like road accidents and suicide, although these only accounted for a tiny proportion of deaths." Previously, "it had been thought that depressed or anxious people were more likely to die early because they failed to take good care of themselves -- perhaps smoking and drinking more, eating worse and doing less exercise." However, according to the study's lead author, stress may alter "the physiology of the body to make it intrinsically less healthy," somehow making it more susceptible to stroke and heart attacks.
ADHD May Be More of a Life or Death Illness than Many Think
Many mental health conditions are associated with a shortened life expectancy, though attention-deficit/
hyperactivity disorder (ADHD) is not necessarily a diagnosis that might come to mind when thinking about illnesses that may lead to a shorter life .ADHD is associated with unintentional injury
in youth, and adults with ADHD are at increased risk for serious traffic accidents . ADHD is also associated with a variety of difficulties that might be associated with a shortened life, such as substance use disorders, criminality, and more severe psychiatric comorbidities . While some of this bears out logically,
very little research has actually explored the relationship between ADHD and dying earlier .A group of researchers in Denmark used a Danish national register to follow 1 .92 million individuals, including over 32,000 with ADHD, from their first birthday until the year 2013 .Adjusting for calendar year, age, sex, family history of psychiatric illness, age of parents, and various socioeconomic factors, the researchers compared mortality in individuals both with and without ADHD .Over the follow-up period of 24 .9 million person-years (number of people followed times the number of years they were followed), more than 5,000 individuals died .Individuals with ADHD died at a rate of 5 .9 per 10,000 person years compared to 2 .2 per 10,000 in the non-ADHD group .Accidents were the most common cause of death .The greatest differences were actually observed in adults, with the relative risk of dying in the ADHD group in adults was four times greater than the non-ADHD group .In comparison, youth with ADHD were only 1 .9 (younger than 6) or 1 .6 (aged 6-17 years) times more likely to die than their non-ADHD counterparts .Even after excluding comorbid oppositional defiant disorder, conduct disorder and substance use, the mortality rate was still about 50% greater in the ADHD group .Perhaps most (or least) surprising, these controlled effects were dramatically higher in women, whose relative risk for death of 2 .9 (95% CI 1 .6-4 .7) dwarfed that of boys and men (1 .3, 95% CI 0 .9-1 .8) .The latter may be due to the fact that women diagnosed with ADHD tend to have much more severe symptoms than men with ADHD, at least at younger ages, given biases in ADHD criteria that focus on symptoms most commonly noticeable in boys .Girls simply have to be sicker to be referred for treatment than boys do .The value of this study is not in giving clinicians fuel to scare our patients into taking their medications, it certainly highlights the degree to which impulsivity can get both children and adults with ADHD into trouble, and should
inform the psycho-education we provide, especially to girls and women with ADHD .
"Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study . Lancet 2015 Feb 26"
