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Attention-deficit/hyperactivity disorder and physical multimorbidity: A population-based study

Published online by Cambridge University Press:  23 March 2020

A. Stickley*
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge141 89, Sweden Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 HongoBunkyo-ku, Tokyo113-0033, Japan
A. Koyanagi
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas42, Sant Boi de LlobregatBarcelona08830, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11Madrid28029, Spain
H. Takahashi
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan
V. Ruchkin
Child Study Centre, Yale University Medical School, New Haven, CT06520, USA Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala751 85, Sweden
Y. Inoue
Carolina Population Center, The University of North Carolina at Chapel Hill137, East Franklin StreetChapel Hill, NC, USA
Y. Kamio
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 OgawahigashiKodaira, Tokyo187-8553, Japan
*Corresponding author. Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan. Fax: +81 42 346 1944. E-mail (A. Stickley).
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There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e. = 2 physical diseases) among adults in the English general population.


Data were analyzed from 7274 individuals aged = 18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.


There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score = 14). Compared to those with no diseases, individuals with = 5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48–4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3–24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.


Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.

Original article
Copyright © European Psychiatric Association 2017

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