ADHD symptoms and suicide attempts in adults with mood disorders: An observational naturalistic study

Abstract

• In a sample of adults, ADHD symptoms were significantly associated with suicide attempt (lifetime and in the last 3 months) only among participants with mood disorders. • Our study suggests that ADHD symptoms among adults with mood disorders might have a role in increasing the risk of suicide attempt only when the two conditions are comorbid. • The present findings stress the importance of evaluating the co-occurrence of ADHD symptoms and mood disorders among adults, and also to carefully assess the risk of suicide in the presence of such comorbidity. • Further research on the mechanisms underlying the moderating role of mood disorders in the association between ADHD symptoms and suicide attempts may lead to a better understanding of preventing suicide in this at-risk group. Although several studies explored the association between ADHD and suicidality in the pediatric population, there is a lack of studies focusing on adults. It is particularly unclear whether comorbid mood disorders confer an increased risk of suicidal ideation and attempt among individuals with high ADHD symptoms. Participants were 111 inpatients admitted to the Department of Psychiatry of Sant'Andrea Hospital between July 2017 and July 2018. Data were collected using self-report questionnaires and semi-structured interviews. Lifetime and last-month suicidal ideation and attempts were rated with The Columbia-Suicide Severity Rating Scale (C-SSRS). Symptoms of ADHD were rated using The Adult ADHD Self-Report Scale Version 1.1 (ASRS-V1.1). Of the 111 participants, 40.6% had a history of suicide attempts. No associations were found between ADHD symptoms and suicide attempt/ideation as well as mood disorder diagnosis and suicide attempt, while an association between mood disorder diagnosis and suicidal ideation was found. ADHD symptoms were significantly associated with suicide attempt (lifetime and in the last 3 months) only among participants with mood disorders (lifetime, OR 2.30; 95% CI: 0.97–3.64; 3-months OR 2.34; 95% CI: 0.19–4.49) Given the cross-sectional nature of the study, the directions of the associations described are uncertain. Conclusions: ADHD symptoms were significantly associated with lifetime and recent suicide attempts, only when a mood disorder diagnosis was comorbid. The co-occurrence of ADHD symptoms and a mood disorders diagnosis might confer a higher risk of suicide attempt among adults.