Adolescents and Young Adults With ADHD at Greater Risk of Motor Vehicle Crashes

Adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD) are at a greater risk of being involved in motor vehicle crashes, according to a study recently published in JAMA Pediatrics. The study was performed at 6 primary care practices of the Children’s Hospital of Philadelphia.

“Study results demonstrate the need to provide guidance for families around reducing the elevated crash risk among young drivers with ADHD, yet foundational research and evidence-based recommendations are lacking,” the authors wrote.

The researchers collected a sample of 2470 adolescents and young adults with ADHD, and identified 15,865 participants without ADHD. Each subject had to have been born between 1987 and 1997, a New Jersey resident, and a patient at 1 of the 6 New Jersey primary care practices when they were at least 12 years old, and were the correct age to obtain a driver’s license from 2004 through 2014. Then, data from electronic health records were linked to the New Jersey driver licensing and crash databases from 2004 to 2014.

The results were measured based on when an individual obtained their driver’s license and their first police-reported crash as a driver. The probability of a young adult with ADHD receiving his or her license 6 months after eligibility was 35% lower than their counterparts without ADHD. Additionally, of the 1785 individuals with ADHD and a driver’s license, 764 (42.8%) crashed during the study period, while only 35.7% (4715 of 13,221) of those without ADHD crashed.

Licensed drivers with ADHD had an adjusted risk for their first crash that was 1.36 times greater than those without ADHD and was consistent among sex, licensing age, and over time. Although medication has the potential to help those with ADHD, only 129 ADHD patients (12.1%) were prescribed medication during the 30 days prior to when the individual obtained their license.

“Adolescents with ADHD get licensed less often and at an older age. Once licensed, this cohort has a greater risk of crashing,” the authors concluded. “Additional research is needed to understand the specific mechanisms by which ADHD influences crash risk.”