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People with ADHD who experience severe financial distress at fourfold higher risk of suicide: Study

Adults with ADHD were more than four times more likely than others to have bank overdrafts, unpaid alimony, unpaid educational support, unpaid road taxes and impounded property
(Getty Images)
(Getty Images)

Financial distress could be linked to suicide risk in people with attention-deficit/hyperactivity disorder (ADHD). A research team has found that people with ADHD, who also had the highest risk of credit default, were four times more likely to commit suicide than those with only one of these two risk factors. Overall, the results of the study suggest that more attention should be given to the financial difficulties faced by those with ADHD and how it may affect their mental health. 

“Even when you take into account the other problems faced by those with ADHD, we found financial distress plays a key role in suicide. Our modern life is built on paying bills on time and making rent and mortgage payments. These tasks are more difficult for people with ADHD and it takes a toll,” writes study author Theodore Beauchaine, Department of Psychology, College of Arts and Sciences, The Ohio State University, US. 

While individuals with ADHD started adulthood with about the same credit demand and default risk as anyone else, the analysis shows that their default rates ballooned above average in middle age, resulting in a greater risk of financial issues. The findings also indicate that overdue debts remained unchanged in the two years before and after people with ADHD began taking prescriptions to treat the disorder, suggesting ADHD treatments did not enable these people to recover from severe financial distress. 

“The impulsivity found in ADHD is predisposing to suicide. And if you have a lifetime of financial problems, that can lead to a sense of hopelessness. Hopelessness combined with impulsivity is a really bad combination and may increase the risk of suicide,” warns Beauchaine.

The findings

Despite the awareness that adults with ADHD may be more likely to struggle with finances, there have been few objective studies to measure the extent of these difficulties and their effect on wellbeing, say experts. Accordingly, to assess the relationship between financial behaviors and suicide risk in adults with ADHD, the team analyzed data on ADHD and suicide from 2002 to 2015 for all 11.5 million adults in Sweden, available through a Swedish government agency. They also obtained credit and default data for a random sample of 189,267 Swedish residents for the same period.

The report, which includes changes in financial behaviors in the months and years leading up to suicides, reveals the important role that financial problems play in the risk of suicide for people with ADHD. ADHD is not diagnosed as much in Sweden or the rest of Europe as it is in the US, but the results of this study most likely apply to the US, say investigators. 

People with ADHD started adulthood with about the same credit demand and default risk as anyone else, but their default rates ballooned above average in middle age. (Getty Images)

The authors found that people diagnosed with ADHD showed only a slightly higher demand for credit compared to others before age 30. But their demand for credit continued to grow at later ages when the rest of the population lowered its demand. This gap in demand stems from credit requests by those with ADHD being rejected. Adults with ADHD were more than four times more likely than others to have bank overdrafts, unpaid alimony, unpaid educational support, unpaid road taxes and impounded property. By age 40, their default risk peaked at more than six times that of the general population. “Because they are in financial distress, those with ADHD keep asking for more credit and not getting it. The result is that their financial problems just keep getting worse and worse through adulthood,” explains study author Itzhak Ben-David, Department of Finance, Fisher College of Business at The Ohio State University. 

Overall, people with ADHD were more likely to die by suicide than those who did not have ADHD. However, adults with ADHD who were at the highest risk of default were about four times more likely to die of suicide than those with ADHD who were at low risk of default and people without an ADHD diagnosis who had poor credit. “Attention deficit hyperactivity disorder is linked to higher levels of financial distress in adults, and a fourfold higher risk of suicide for those with the most debt,” the findings state.

The analysis also reveals that men with ADHD who committed suicide experienced increased outstanding debt during the three years before their deaths -- a finding that requires further research to explain, the authors note. The connection between recent debt and suicide was not found in women. While the data cannot explain why, Ben-David says it could be because of traditional gender roles that dictate that men are responsible for the financial security of their families. 

According to the investigators, patients who were prescribed drugs to treat ADHD did not have better financial outcomes than those who did not, but they add that this finding should be interpreted with caution. It is possible that prescription medications were helpful to those who regularly filled their prescriptions and took them as prescribed, but data on medication adherence was not available, the report explains. “Overall, our findings add to a growing literature indicating widespread and persistent functional impairment among adults diagnosed with ADHD and highlight the need for more effective treatments across the lifespan,” say researchers. They add, “Future studies should address important questions regarding medication adherence, financial behaviors, and their associations with suicide to determine whether sympathomimetic prescriptions are helpful for those who take them as prescribed and whether such medications are more versus less helpful for some individuals with ADHD than others.”