Serious Transport Accidents in Adults With Attention-Deficit/Hyperactivity Disorder and the Effect of Medication: A Population-Based Study
Open accessAbstract
IMPORTANCE: Studies have shown that attention-deficit/hyperactivity disorder (ADHD) is associated with transport accidents, but the magnitude of the association remains unclear. Most important, it is also unclear whether ADHD medication reduces this risk. OBJECTIVES: To estimate the association between ADHD and the risk of serious transport accidents and to explore the extent to which ADHD medication influences this risk among patients with ADHD. DESIGN, SETTING, AND PARTICIPANTS: In total, 17,408 patients with a diagnosis of ADHD were observed from January 1, 2006, through December 31, 2009, for serious transport accidents documented in Swedish national registers. The association between ADHD and accidents was estimated with Cox proportional hazards regression. To study the effect of ADHD medication, we used stratified Cox regression to compare the risk of accidents during the medication period with the risk during the nonmedication period within the same patients. MAIN OUTCOMES AND MEASURES: Serious transport accident, identified as an emergency hospital visit or death due to transport accident. RESULTS: Compared with individuals without ADHD, male patients with ADHD (adjusted hazard ratio, 1.47; 95% CI, 1.32-1.63) and female patients with ADHD (1.45; 1.24-1.71) had an increased risk of serious transport accidents. In male patients with ADHD, medication was associated with a 58% risk reduction (hazard ratio, 0.42; 95% CI, 0.23-0.75), but there was no statistically significant association in female patients. Estimates of the population-attributable fractions suggested that 41% to 49% of the accidents in male patients with ADHD could have been avoided if they had been receiving treatment during the entire follow-up. CONCLUSIONS AND RELEVANCE: Attention-deficit/hyperactivity disorder is associated with an increased risk of serious transport accidents, and this risk seems to be possibly reduced by ADHD medication, at least among male patients. This should lead to increased awareness among clinicians and patients of the association between serious transport accidents and ADHD medication.
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Traffic accidents and violations are more frequent in drivers with ADHD than in those without the disorder.
“Traffic accidents and violations are more frequent in drivers with ADHD 121,217,218 than in those without the disorder”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [217]
The Results report a higher risk of serious transport accidents in adults with ADHD than in controls. The paper’s stated outcome is serious transport accidents; our copy does not report a comparison of traffic violations, so that part of the claim is unsupported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredTreatment discontinuation places individuals with ADHD at higher risk for catastrophic outcomes, such as motor vehicle crashes, criminality, including drug-related crimes and violent reoffending, depression, interpersonal issues, and other injuries.
“Treatment discontinuation also places individuals with ADHD at higher risk for catastrophic outcomes, such as motor vehicle crashes78,79; criminality, including drug-related crimes77 and violent reoffending76; depression71; interpersonal issues80; and other injuries.81,82”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [79]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThere are risks of driving for adolescents with ADHD, including crashes and motor vehicle violations.
“Given the risks of driving for adolescents with ADHD, including crashes and motor vehicle violations, special concern should be taken to provide medication coverage for symptom control while driving.79,136,137”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [79]
The Discussion (page not provided) reports an increased rate of serious transport accidents among adults with ADHD, and an association between medication use and fewer accidents among male adults. It does not establish these findings specifically for adolescents or report motor vehicle violations. (LLM, conf=0.87)
Experimental — accuracy not yet measuredFamily relationships involving individuals with ADHD might be characterized by discord and negative interactions compared with families unaffected by ADHD.
“family relationships involving indivi duals with ADHD might be characterized by discord and negative interactions compared with families unaffected by ADHD 217,219-221 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [217]
The Results and Discussion report serious transport accidents and ADHD medication, not family relationships. Searches for family discord and negative interactions found no passage in our copy addressing those outcomes; the reference to relatives concerns psychiatric risk, not family interactions. No page numbers are available in the indexed passages. (LLM, conf=0.75)
Experimental — accuracy not yet measured
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- Authors
- Chang, Z., Lichtenstein, P., D’Onofrio, B. M., Sjölander, A., & Larsson, H.
- Affiliations
- Karolinska Institutet (SE)
- Department of Psychological and Brain Sciences, Indiana University, Bloomington
- Corresponding author
- Chang, Zheng
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2014-03-01
- Volume
- 71
- Issue
- 3
- Pages
- 319
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC3949159
- OpenAlex
- W2120831849
- Cited by
- 293
- References
- 32
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 24 · 2023: 20 · 2022: 25 · 2021: 25 · 2020: 37 · 2019: 34 · 2018: 24 · 2017: 24 · 2016: 24 · 2015: 18 · 2014: 10 · 2012: 1
- FWCI
- 19.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061817, HD061817)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- attention deficit hyperactivity disorder, transport accidents, ADHD medication, risk mitigation, sex differences, population attributable fraction, emergency department visits, road safety
- MeSH terms
- Accidents, Traffic, Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Middle Aged, Registries, Risk, Sex Factors, Sweden, Proportional Hazards Models, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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