The risk for suicidality is high among children with attention-deficit hyperactivity disorder (ADHD) and may be mediated by family functioning, according to study data published in the Journal of Affective Disorders.
A cross-sectional survey captured psychiatric diagnoses including ADHD, family functioning, and sociodemographic characteristics among 4739 schoolchildren age 7 to 15 years in Taiwan. Suicidality was assessed by the presence of 3 characteristics: suicidal ideation, a current suicide plan, and a history of suicide attempts. Logistic regression analyses were conducted to assess suicidality risk among children with ADHD. Serial multiple mediator models were used to capture the mediating effects of family function and psychiatric comorbidities on suicidality in ADHD.
Of the total schoolchildren cohort, 412 (8.7%) had an ADHD diagnosis. The prevalence of ADHD differed between boys (12.3%) and girls (4.8%). Suicidality was present in 20% of children with ADHD. Among those who had current suicidal ideation, a suicide plan, and a history of suicide attempts, the prevalence of ADHD was 19.86%, 21.82%, and 22.86%, respectively. In the adjusted model, children with ADHD had nearly a 4-fold higher risk for suicidal ideation compared with children who did not have ADHD (adjusted odds ratio [AOR], 3.82; 95% CI, 2.73-5.34). Risks were similarly elevated for suicide attempts (AOR, 4.45; 95% CI, 1.99-9.93) and having a suicide plan (AOR, 4.18; 95% CI, 2.57-6.80). ADHD maintained a strong impact on suicidality risk even with the mediating effects of family function and psychiatric comorbidities. ADHD was significantly associated with lower family function (P <.001) and higher levels of anxiety/depression (P <.001). After considering these mediating pathways, the association between suicidal ideation and ADHD remained significant (P <.01).
These data emphasize the elevated need for suicidality prevention in children with ADHD and highlight effective areas of interventions. Clinicians may find these data useful in considering the mediating effects of family function and psychiatric comorbidities among patients with ADHD.
Chen Y-Y, Chen Y-L, Gau S S-F. Attention-deficit hyperactivity disorder and suicidality: the mediating effects of psychiatric comorbidities and family function. J Affect Disord. 2019;242:96-104.