Evaluation of clinical and suicidal behavior characteristics among urban, Turkish middle-age depressive patients with comorbid attention deficit hyperactivity disorder

Abstract

Background:In the presence of attention deficit hyperactivity disorder (ADHD) together with additional psychiatric diseases, the treatment process and prognosis of both ADHD and psychiatric comorbidity are adversely affected.Aims:The aim of this study is to compare the characteristics concerning suicidal behavior of the patients diagnosed with major depressive disorder either having (ADHD+) or not having (ADHD−) adult ADHD comorbidity and their responses to depression treatment.Materials and Methods:Ninety-six inpatients were included in the study. Sociodemographic data form, the Hamilton Depression Rating Scale (HDRS), the Wender Utah Rating Scale (WURS), the Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale, and the Personal and Social Performance Scale (PSP) were applied to the cases.Results:HDRS scores were found to be significantly high (P < 0.000) in the ADHD+ group during admission and discharge. However, there was no difference found in terms of PSP scores (P = 0.46) during discharge. In the ADHD+ group, the depressive episode started at an earlier age (P < 0.011). The idea of suicide (P < 0.018) and suicidal attempts (P < 0.022) was found to be higher in this group compared to the ADHD− group. ADHD+ patients had more suicidal attempts requiring more medical intervention (P < 0.001).Conclusion:Depression starts at an early age in individuals with comorbid ADHD diagnosis, and the progress of the depression treatment changes negatively. This patient group is at greater risk in terms of suicidal behavior. Therefore, it should be considered by the clinicians that ADHD can associate with depression while making the follow-up plans for the cases diagnosed with depression.

Risk factors of suicidal spectrum behaviors in adults and adolescents with attention-deficit / hyperactivity disorder – a systematic review

“…Since SSBs are a broad concept, several studies have investigated more than one aspect of SSBs. This accounts for 14 of the studies included in the review [ 23 , 26 , 28 , 29 , 34 , 35 , 37 – 39 , 43 – 46 , 49 ].…”

“…SA or acts are the most common behavior investigated. We identified 12 studies that investigated SI or thoughts as one of their outcomes [ 23 , 26 , 28 , 31 , 32 , 34 , 35 , 38 , 39 , 41 , 43 , 45 ], while 11 studies focused on aspects of self-injurious behavior [ 28 , 29 , 33 , 34 , 37 , 43 – 46 , 49 , 52 ] (Table 2 ).…”

“…In a study conducted by Delibas et al . [ 26 ] , patients with MDD and ADHD had significantly higher rates of SI ( p < 0.018)) than patients without comorbid ADHD. There were no significant differences between adults with and without comorbid ADHD in a clinical sample of bipolar patients ( p = 0.24) [ 38 ].…”

“…A total of 16 articles investigated risk of SSBs in individuals with ADHD as a comorbid disorder to another psychiatric disorder, such as a major depressive disorder (MDD), bipolar disorder (BD), anxiety disorders, SUD, Tourette syndrome (TS) and chronic fatigue syndrome (CFS) [19,25,26,31,38,41,43,[51][52][53][54][55][56][57][58]. One study compares individuals who have ADHD with and without comorbid anxiety disorders [21].…”

“…Patients with MDD and ADHD were more likely to have engaged in SA (p < 0.001) than patients without comorbid ADHD, and showed higher mean scores on Hamilton Depression Rating Scale (HDRS) during admission and discharge [26]. Harmanci et al examined patients with BD or MDD and compared SA in the participants with and without comorbid ADHD [53].…”