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While Utah's altitude may be putting residents at higher risk of depression and suicide, could it also be protecting them from attention deficit hyperactivity disorder?

A new study from the University of Utah has found the prevalence of ADHD decreases substantially at higher altitudes.

Delaware, Louisiana and states with an average elevation of less than 1,000 feet above sea level had the highest percentage of children diagnosed with ADHD — led by North Carolina's 15.6 percent.

Nevada, which has an average elevation of 5,517 feet above sea level, had the lowest percentage, at 5.6. Utah had one of the lowest rates, at 6.7 percent.

All of the Mountain West states — which generally have a pattern of high mental illness and suicide rates but otherwise healthy residents — rated well below average for the percentage of children diagnosed with ADHD.

One potential reason, according to U. researchers, is that people at higher elevations are breathing air with less oxygen, which triggers the body to produce higher levels of dopamine. Since ADHD is associated with decreased dopamine, the risk for getting the disorder diminishes as the level of the hormone increases.

The study findings, published in the Journal of Attention Disorders online, have potential implications for treating ADHD, according to physician Douglas G. Kondo, assistant professor of psychiatry and senior author on the study.

Previous studies consistently suggest that hypobaric hypoxia, a condition caused by the lower oxygen levels at higher altitudes, "may serve as a kind of environmental stressor," Kondo said in a statement. "But these results raise the question of whether, in the case of ADHD, altitude may be a protective factor."

University researchers used data from two national health surveys to conduct the study, as well as information on average state elevations.

By comparing ADHD diagnosis rates with average elevations, researchers found that for every foot of increased elevation, the likelihood of being diagnosed with ADHD decreased by .001 percent. The study also considered factors — such as birth weight, ethnicity and sex — that could affect ADHD diagnoses and rates in each state. Males are more likely to have the disorder.

Perry F. Renshaw, a University of Utah professor of psychiatry, agreed the study may provide insights for treatment.

"To treat ADHD we very often give someone medication that increases dopamine," he says. "Does this mean we should be increasing medications that target dopamine? Parents or patients might want to take this information to their health care providers to discuss it with them."

In an interview, Kondo said the study is the first of its kind, creating a hypothesis that requires further study. "We need to know much more," he said. "We're just at the very beginning."

But he added that if the relationship between altitude and ADHD is proven, it would assist clinicians working with families and provide insight into the neurobiology and causes of ADHD.

So should families move to Salt Lake City or Denver to avoid the disorder?

"If they like skiing, they should," Kondo said. —

ADHD in Utah

Utah's average elevation is 6,100 feet, and its rate of diagnosed ADHD cases is about 50 percent of the rate seen in states at sea level.

Salt Lake City has an elevation of about 4,300 feet and its ADHD prevalence is approximately 38 percent less than rates at sea level.