Attention‐deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients

• Published in: Psychiatry and clinical neurosciences 2018-09, Vol.72 (9), p.713-722
• Main Authors: Stickley, Andrew, Tachimori, Hisateru, Inoue, Yosuke, Shinkai, Takahiro, Yoshimura, Reiji, Nakamura, Jun, Morita, Gihei, Nishii, Shigeki, Tokutsu, Yuki, Otsuka, Yuka, Egashira, Kazuteru, Inoue, Miyuki, Kubo, Takamitsu, Tesen, Hirofumi, Takashima, Naoyuki, Tominaga, Hirotaka, Koyanagi, Ai, Kamio, Yoko
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anxiety; attempted suicide; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Behavior disorders; Comorbidity; Cross-Sectional Studies; Female; Humans; Hyperactivity; Japan; Japan - epidemiology; Male; Mental disorders; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Middle Aged; Outpatients; Prevalence; Self destructive behavior; Suicidal behavior; Suicidal Ideation; Suicide; Suicide, Attempted - statistics & numerical data; Suicides & suicide attempts; Young Adult
• ISSN: 1323-1316; 1440-1819; 1440-1819
• DOI: 10.1111/pcn.12685

Aim We aimed to examine the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders. Methods Cross‐sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care, which included psychiatric outpatients aged 18–65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan from April 2014 to January 2015 (N = 864). The Adult ADHD Self‐Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior. Results After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose–response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD‐10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder, ADHD symptoms were significantly linked to all forms of suicidal behavior. Conclusion ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior.