In the Journals

Vehicular crashes more common in teens with ADHD

Newly licensed adolescents with attention-deficit/hyperactivity disorder are 1.36 times more likely to experience a vehicular crash than teenagers without the condition, according to a study published in JAMA Pediatrics.

This research counters previously published research that suggests that the risk is nearly four times higher in those with ADHD.

“Along with benefits of mobility and independence, driving increases the risk of a motor vehicle crash — the leading cause of death in U.S. adolescents,” Allison E. Curry, PhD, from the Center of Injury Research and Prevention at the Children’s Hospital of Philadelphia, and colleagues wrote. “Of particular concern is that defining symptoms of ADHD — inattention, hyperactivity and impulsivity — have been linked to unsafe driving behaviors, creating the potential for heightened adverse health risk for adolescents with ADHD.”

The researchers analyzed the association between driver’s licensing for adolescents with ADHD, crash involvement and whether any variation exists in relation to gender, age or whether medication used to treat the condition in teenagers is involved. To do this, they conducted a retrospective cohort study in which the electronic health records of 2,479 teenagers with ADHD and 15,865 without ADHD, all of whom received treatment at six primary care locations at the Children’s Hospital of Philadelphia, were examined.

For teenagers to be included in the study, they must have been born between 1987 and 1997, must reside within the state of NJ and be patients at the organization’s six primary care practices, must be at least 12 years of age and must be eligible for licensure during the time of the study. All data obtained through EHR were connected with New Jersey’s licensing and crash databases.

The chances of a teenager obtaining a driver’s license 6 months after eligibility was 35% lower if they had ADHD (for boys: adjusted HR = 0.65 [95% CI: 0.61, 0.70]; females: aHR = 0.64 [0.58, 0.70]). Throughout the duration of the study, 42.8% of adolescents with the condition crashed their vehicle compared to 35.7% without ADHD, making those with the condition 1.36 times more likely to crash (95% CI: 1.25, 1.48).

These levels of risk were not affected by the gender, licensing age, medication or time spent driving. Of the teenagers involved with ADHD, 12% were prescribed medication 30 days before licensure.

“Studies among community samples of children with ADHD have suggested that symptom profiles may differ in ways that would affect driving. Boys may experience greater hyperactivity, impulsivity and externalizing problems and girls more internalizing problems and potentially higher risks of inattention,” Curry and colleagues wrote. “Future research should examine males and females separately to uncover potential gender-based mechanisms underlying increased crash risk among adolescent drivers with ADHD.”

Disclosure: The researchers provide no relevant financial disclosures.

Newly licensed adolescents with attention-deficit/hyperactivity disorder are 1.36 times more likely to experience a vehicular crash than teenagers without the condition, according to a study published in JAMA Pediatrics.

This research counters previously published research that suggests that the risk is nearly four times higher in those with ADHD.

“Along with benefits of mobility and independence, driving increases the risk of a motor vehicle crash — the leading cause of death in U.S. adolescents,” Allison E. Curry, PhD, from the Center of Injury Research and Prevention at the Children’s Hospital of Philadelphia, and colleagues wrote. “Of particular concern is that defining symptoms of ADHD — inattention, hyperactivity and impulsivity — have been linked to unsafe driving behaviors, creating the potential for heightened adverse health risk for adolescents with ADHD.”

The researchers analyzed the association between driver’s licensing for adolescents with ADHD, crash involvement and whether any variation exists in relation to gender, age or whether medication used to treat the condition in teenagers is involved. To do this, they conducted a retrospective cohort study in which the electronic health records of 2,479 teenagers with ADHD and 15,865 without ADHD, all of whom received treatment at six primary care locations at the Children’s Hospital of Philadelphia, were examined.

For teenagers to be included in the study, they must have been born between 1987 and 1997, must reside within the state of NJ and be patients at the organization’s six primary care practices, must be at least 12 years of age and must be eligible for licensure during the time of the study. All data obtained through EHR were connected with New Jersey’s licensing and crash databases.

The chances of a teenager obtaining a driver’s license 6 months after eligibility was 35% lower if they had ADHD (for boys: adjusted HR = 0.65 [95% CI: 0.61, 0.70]; females: aHR = 0.64 [0.58, 0.70]). Throughout the duration of the study, 42.8% of adolescents with the condition crashed their vehicle compared to 35.7% without ADHD, making those with the condition 1.36 times more likely to crash (95% CI: 1.25, 1.48).

These levels of risk were not affected by the gender, licensing age, medication or time spent driving. Of the teenagers involved with ADHD, 12% were prescribed medication 30 days before licensure.

“Studies among community samples of children with ADHD have suggested that symptom profiles may differ in ways that would affect driving. Boys may experience greater hyperactivity, impulsivity and externalizing problems and girls more internalizing problems and potentially higher risks of inattention,” Curry and colleagues wrote. “Future research should examine males and females separately to uncover potential gender-based mechanisms underlying increased crash risk among adolescent drivers with ADHD.”

Disclosure: The researchers provide no relevant financial disclosures.