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Update on Environmental Risk Factors for Attention-Deficit/Hyperactivity Disorder

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Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder affecting 5% to 10% of children. Although considered to be a highly familial disorder, ADHD heritability estimates of 60% to 80% highlight the considerable role that environmental factors may still play in disorder susceptibility. Proposed ADHD environmental risk factors include prenatal substance exposures, heavy metal and chemical exposures, nutritional factors, and lifestyle/psychosocial factors. This paper reviews the literature published in 2010 investigating the association between environmental risk factors and ADHD or related symptomatology. Sources of risk factor exposure and the proposed mechanism by which each exposure is linked to ADHD-related neurobehavioral changes are also reported. Methodologic limitations of the current literature are discussed, and guidelines for future study are proposed. An improved understanding of the role that environmental factors play in ADHD etiology is critical to future ADHD prevention efforts.

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Acknowledgments

Manuscript preparation was supported by the National Institute of Mental Health (grant no. K23 MH083881 to Dr. Froehlich).

Dr. Anixt received honoraria from the American College of Physicians Physicians’ Information and Education Resource for co-authoring and later editing/updating an online point-of-care, evidence-based review of ADHD.

The content of this paper is solely the responsibility of the authors and does not represent the official views of the National Institute of Mental Health or the National Institutes of Health.

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No potential conflict of interests relevant to this article were reported.

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Authors and Affiliations

  1. Cincinnati Children’s Hospital, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH, 45229, USA

    Tanya E. Froehlich, Julia S. Anixt, Vilawan Chirdkiatgumchai, Lisa Kuan & Richard C. Gilman

  2. Stanford University School of Medicine, 750 Welch Road, Suite 315, Palo Alto, CA, 94304, USA

    Irene M. Loe

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  1. Tanya E. Froehlich
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Correspondence to Tanya E. Froehlich.

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Froehlich, T.E., Anixt, J.S., Loe, I.M. et al. Update on Environmental Risk Factors for Attention-Deficit/Hyperactivity Disorder. Curr Psychiatry Rep 13, 333–344 (2011). https://doi.org/10.1007/s11920-011-0221-3

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