The relationship between ADHD symptomatology and self-harm, suicidal ideation, and suicidal behaviours in adults: a pilot study

Abstract

The aim of this study was to explore whether individuals with attention-deficit/hyperactivity disorder (ADHD) are at risk of harm over the lifespan due to increased rates of self-harm, suicidal ideation and suicidal behaviour, and whether this association is mediated by psychosocial factors. Sixty-six adults (43 men, 23 women; 18-65 years) participated in this study involving clinical interview and retrospective self-report measures of ADHD symptoms, self-harm/suicidal behaviour, mental health disorders, and coping style measures. Significant associations were found between ADHD symptom severity and self-reported histories of self-harm behaviour, suicidal ideation, and suicide attempts (all p values<.05). These relationships between self-destructive behaviours and ADHD symptom severity were found to be significantly and differentially mediated by psychosocial variables (all p values<.05) including comorbidity (mood, anxiety, drug, and alcohol abuse disorders) and emotion-focussed coping style. This study suggests that linkages between self-injurious behaviour and ADHD symptomatology may be due primarily to comorbid mental health disorders and emotion-focussed coping. The identification of these mediating factors and processes may potential pathways for intervention in reducing suicide and self-harm risk amongst those with ADHD symptoms.

Attention-deficit/hyperactivity disorder and suicide: A systematic review

“…Suicidality in ADHD patients who have psychiatric comorbidity: From the 26 papers of this review, the 10 studies, which investigated comorbidity in ADHD patients with suicidality are presented in Table 4[27,28,35-39,47,48]. …”

Comorbidity of Adult Attention Deficit and Hyperactivity Disorder in Bipolar and Unipolar Patients

“…A review of the literature here again indicated contradictory findings. While there were studies observing no difference between bipolar patients with and without ADHD comorbidity in terms of suicide attempt history (15,23), others reported significantly more suicide attempts in the group with comorbidity (11,30,33,34,35). Since the patients diagnosed with both diseases experience impulsivity, difficulty in controlling themselves, and negative life events more frequently, suicide attempts may be expected (36).…”

Self-injury and externalizing pathology: a systematic literature review

“…Persistent ADHD also differed significantly from comparsion groups (transient ADHD and control) in NSSI frequency, variety and severity (Cohen’s d: 0.32–0.87; p  < 0.05). Externalizing symptoms mediate between ADHD and NSSI (IE = 0.29; SE = 0.11; CI 95%: 0.10–0.51).Taylor et al (2014) [44]New-Zealandcase–control study, patients with retrospective ADHD and control groupM = 31.9; SD = 1.666 (35 with adult ADHD and 31 with no ADHD)DSHYesquestionnaire for DSH; DSHISignificant associations were present between ADHD symptom severity and history of self-harm behaviour, suicidal ideation and suicide attempts. These relationships were mediated by comorbidity (mood, anxiety, drug and alcohol abuse disorders) and emotion-focused coping style.…”