title: Traffic and Criminal Behavior of Adults with Attention Deficit-Hyperactivity with a Prospective Follow-Up from Birth to the Age of 40 Years.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether individuals with attention deficit-hyperactivity disorder (ADHD) followed up to age 40 have a higher mortality, more involvement in criminal behavior, increased traffic accidents, and frequency or registered violations against traffic rules or whether they have been more frequently victims to crimes.
  
  
  METHODS
  The ADHD cohort (N = 122) born in 1971-1974 was isolated at the age of 9 years from the base cohort of 865 children who had known risk factors at birth and were still alive at the age of 5 years. Ninety-four healthy individuals born during the same years served as control subjects. None of the individuals with ADHD had used psychostimulants before their adolescence. The follow-up data were available from the newborn period until the ages of 5 and 9 years. At the ages of 16 and 30, the data were collected via questionnaire. For this study, the national police registers (last 5 years) were examined for traffic violations, crimes, or being an object of a criminal act when the persons reached the age of 40 years.
  
  
  RESULTS
  Ten men and one woman with ADHD but none of the controls had died by the age of 40. Three died of disease-related incidents, and 8 (13%) died of abnormal causes such as suicide (3), traffic accident (2), substance abuse (2), or violence (1). During the follow-up period, individuals with ADHD had been involved in violent behavior or economic criminality more frequently than the control subjects. They were also more commonly victims of criminal acts. No difference was found in traffic citations between those with ADHD and control subjects (at 35-40 years) when all traffic crimes were considered. A difference was not observed in the frequency of traffic accidents. However, there was a significant difference in drunk driving (at the ages of 30 and 35-40) and the number of persons without a driver's license.
  
  
  CONCLUSIONS
  Subjects with ADHD showed an elevated risk of being involved in criminality and had a higher risk of dying before the age of 40 years. The early detection of ADHD in childhood and appropriate treatments and family support may decrease criminality and save both money and human distress.
authors.affiliation: a Finnish Motor Insurers' Centre , Helsinki , Finland.|b Department of Engineering Design and Production, Aalto University , Aalto , Finland.
authors.forename: Tapio
authors.initials: T
authors.lastname: Koisaari
authors.affiliation: c Pediatrics, Helsinki University , Helsinki , Finland.
authors.forename: Katarina
authors.initials: K
authors.lastname: Michelsson
authors.affiliation: d Department of Ophthalmology, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Juha M
authors.initials: JM
authors.lastname: Holopainen
authors.affiliation: e National Traffic Police , Helsinki , Finland.
authors.forename: Risto
authors.initials: R
authors.lastname: Maksimainen
authors.affiliation: e National Traffic Police , Helsinki , Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Päivänsalo
authors.affiliation: e National Traffic Police , Helsinki , Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Rantala
authors.affiliation: d Department of Ophthalmology, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Tervo
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D016022:Case-Control Studies; D019548:Crime Victims / Q000706:statistics & numerical data; D000066479:Criminal Behavior; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D011446:Prospective Studies; D018570:Risk Assessment
keywords: ADHD; criminality; driver's license; mortality; traffic violations