Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm

Ping-I Lin; Weng Tong Wu; Enoch Kordjo Azasu; Tsz Ying Wong

doi:10.1016/j.psychres.2024.115936

Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm

Psychiatry Res. 2024 Apr 29:337:115936. doi: 10.1016/j.psychres.2024.115936. Online ahead of print.

Authors

Ping-I Lin¹, Weng Tong Wu², Enoch Kordjo Azasu³, Tsz Ying Wong²

Affiliations

¹ Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, New South Wales, Australia; Department of Mental Health, Western Sydney University, New South Wales, Australia; Neuroscience Research Australia, Australia. Electronic address: daniel.lin@unsw.edu.au.
² Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, New South Wales, Australia.
³ Department of Psychiatry and Neurobehavioral Science, Saint Louis University, Missouri, USA.

PMID: 38705042
DOI: 10.1016/j.psychres.2024.115936

Abstract

To evaluate the effect of ADHD diagnosis by the age of 10 on the suicide/self-harm risk at age 14 and examine factors that may modify/mediate the association, a longitudinal study based on the nationwide survey consisting of 5,107 children in Australia was used. Self-harm and suicidal risks in children with ADHD at age 14 were the main outcomes; ADHD medication, history of bullied or depression, and other sociodemographic disadvantages, were treated as covariates. The diagnosis of ADHD at age 10 is associated with elevated risks of self-harm, suicidal thoughts, planning, or attempts by age 14, with greater susceptibility in males. The pathway from ADHD symptoms to suicide/self-harm could also be mediated by depression and exposure to bullying assessed at age 12. Note that depression and exposure to bullying might at best contribute to less than 10 % of the total effect of ADHD diagnosis on either the risk of suicide or self-harm. Early gender-tailored intervention and prevention strategies are crucial in clinical practice and health policy.

Keywords: ADHD; Bullying; Cohort study; Depression; Self-harm; Suicide.