A 3- to 5- year follow-up survey of driving-related risks and outcomes in 35 adolescents and young adults with attention deficit hyperactivity disorder (ADHD) and 36 control subjects is reported from the Departments of Psychiatry, Neurology, and Pediatrics, University of Massachusetts Medical Center, Worcester, MA. ADHD subjects had a significantly greater risk than controls for traffic citations, especially for speeding, motor vehicle crashes, automobile injuries, and unsound driving habits. A subgroup of teenagers with ADHD complicated by oppositional defiant and conduct disorders were at highest risk for deviant driving skills/habits and negative driving-related outcomes. Even before receiving a license, the ADHD group was three times more likely to have driven without a valid license than the control group. During their brief driving careers, the ADHD group was involved in a total of 54 crashes compared with 16 for controls, and they were four times as likely to have been at fault. [1]

COMMENT. These results corroborate previous studies showing a correlation between ADHD in adolescents and young adults and an increased rate of motor vehicle crashes, especially in those not treated with stimulant medication [2]. ADHD patients who continued to take stimulant medication as young adults had no more crashes than a control group. Counselling of ADHD patients and their parents regarding risks of driving and increased potential for crashes and injuries is important. The authors suggest that clinicians may wish to consider continued therapy with methylphenidate in adolescents with severe ADHD in the hope of reducing the risk of driving injuries.