Assessment & Research

The risk of injury in adults with attention-deficit hyperactivity disorder: A nationwide, matched-cohort, population-based study in Taiwan.

Chien et al. (2017) · Research in developmental disabilities 2017
★ The Verdict

Adults with ADHD get hurt far more often, but steady stimulant use shaves off almost a quarter of that risk.

✓ Read this if BCBAs who work with teens or adults with ADHD in day programs, group homes, or transitional living.
✗ Skip if Practitioners who only serve preschoolers or clients without ADHD.

01Research in Context

01

What this study did

Wu-Chien et al. (2017) pulled health records for every adult in Taiwan who has an ADHD diagnosis. They matched each adult to a similar adult without ADHD by age, sex, and income.

Then they counted how many times each group visited a hospital for an injury over one year.

02

What they found

Adults with ADHD landed in the hospital for injuries 2.4 times more often than their matched peers. When they filled a methylphenidate prescription for at least 90 days, their injury risk dropped by 22 percent.

03

How this fits with other research

Farley et al. (2022) saw the same injury spike in kids. They found children with autism plus ADHD had 60 percent higher odds of poisoning-related ER visits. The pattern starts young and carries into adulthood.

Scherf et al. (2008) also saw higher injury treatment in autistic kids, especially for poisoning and self-harm. Wu-Chien moves the lens forward: the risk does not fade after childhood.

Jackson et al. (2025) used the same matched-cohort trick in Denmark. They showed adults with intellectual disability have double the diabetes risk. The take-home: once you have any neurodevelopmental diagnosis, big medical risks follow.

04

Why it matters

If you serve adults with ADHD, add injury prevention to the care plan. Ask about recent falls, burns, or car accidents at every visit. Encourage clients to stay on their stimulant medicine; even a modest drop in injury odds saves money and pain. Share simple safety tips: wear seat belts, label kitchen knives, keep a night-light on stairs. A two-minute chat can prevent a hospital trip.

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Add one safety question to your intake form: 'Any injuries or accidents in the past six months?'

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
2660
Population
adhd
Finding
negative
Magnitude
large

03Original abstract

BACKGROUND: Few studies have investigated the risk of injuries associated with adults with attention-deficit hyperactivity disorder (ADHD), even though several studies have suggested a higher risk of injury in children and adolescents with ADHD. AIMS: To investigate the risk of injury in adults with ADHD. METHODS AND PROCEDURES: We included 665 adults with ADHD from January 1, to December 31, 2000, and 1995 sex-, age- and index day-matched controls without ADHD from the Longitudinal Health Insurance Database (LHID) subset of the National Health Insurance Research Database in Taiwan. The Cox proportional hazard models were used to analyze the associations between the relevant demographics, and the psychiatric comorbidities and the risk of injury. OUTCOMES AND RESULTS: The patients with ADHD had a 143% increased risk of overall injuries than the controls after considering all the confounding factors. In addition, the use of methylphenidate was associated with a 22.6% decrease in the risk of injuries in the patients with ADHD. CONCLUSIONS AND IMPLICATIONS: Our findings strongly support that adults with ADHD are at an increased risk of injury, and imply that methylphenidate therapy may attenuate this risk.

Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.04.011