Association of symptoms of attention deficit-hyperactivity disorder and impulsive-aggression with severity of suicidal behavior in adult attempters

• Published in: Scientific reports Vol. 9; no. 1; p. 4593
• Main Authors: Conejero, I., Jaussent, I., Lopez, R., Guillaume, S., Olié, E., Hebbache, C., Cohen, R. F., Kahn, J. P., Leboyer, M., Courtet, P., Lopez-Castroman, J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14-03-2019; Nature Publishing Group
• Subjects: 631/477/2811; 692/699/476/1311; Adolescent; Adult; Aged; Aged, 80 and over; Aggression; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Children; Diagnosis; Female; Human health and pathology; Humanities and Social Sciences; Humans; Impulsive Behavior; Life Sciences; Male; Mental disorders; Middle Aged; multidisciplinary; Neurons and Cognition; Odds Ratio; Psychiatrics and mental health; Psychology and behavior; Public Health Surveillance; Santé publique et épidémiologie; Science; Science (multidisciplinary); Suicidal behavior; Suicide; Suicide, Attempted; Suicides & suicide attempts; Young Adult; Psychiatric comorbidities; Suicidal behavior(SB); Diagnosis; ADHD symptoms; Deficit-hyperactivity disorder (ADHD)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-41046-y

Literature emphasizes the relationship between attention deficit-hyperactivity disorder (ADHD) and suicidal behavior (SB). However, the link between ADHD and the severity of SB is yet to be determined. We investigated the association between a probable diagnosis of ADHD and the severity of SB in 539 hospitalized suicide attempters, and determined the role of comorbid psychiatric diagnoses. The severity of SB was defined as the number of suicide attempts, age at first suicide attempt, seriousness and violence of suicide attempts. A diagnosis of probable adult ADHD (probable ADHD) was defined as the presence of both current ADHD symptoms and ADHD symptoms in childhood. We evaluated the combined effect of high impulsive-aggression levels and probable ADHD. Probable ADHD was not associated with early or frequent suicide attempts after adjustment for psychiatric disorders and treatment intake. High levels of impulsive-aggression increased the risk of an early suicide attempt, particularly in patients with ADHD symptoms, and independently of other clinical factors. The association between serious suicide attempts and probable ADHD remained significant after adjustment. Although ADHD is involved in suicidal vulnerability, psychiatric comorbidities and impulsive-aggression appear to largely explain the severity of SB in adult attempters with ADHD symptoms.