Attention‐deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients |
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| Authors: | Andrew Stickley PhD Hisateru Tachimori PhD Yosuke Inoue PhD Takahiro Shinkai MD PhD Reiji Yoshimura MD PhD Jun Nakamura MD PhD Gihei Morita MD Shigeki Nishii MD Yuki Tokutsu MD Yuka Otsuka MD Kazuteru Egashira MD PhD Miyuki Inoue MD Takamitsu Kubo MD Hirofumi Tesen MD Naoyuki Takashima MD Hirotaka Tominaga MD Ai Koyanagi MD PhD Yoko Kamio MD PhD |
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| Institution: | 1. Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan;2. Stockholm Center for Health and Social Change, S?dert?rn University, Huddinge, Sweden;3. National Center of Neurology and Psychiatry, Tokyo, Japan;4. Carolina Population Center, University of North Carolina at Chapel Hill, North Carolina, USA;5. Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan;6. Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Foundation, University of Barcelona, Barcelona, Spain;7. Carlos III Health Institute, Center for Biomedical Research in Mental Health Network, Madrid, Spain |
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| Abstract: | Aim We aimed to examine the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders. Methods Cross‐sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care, which included psychiatric outpatients aged 18–65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan from April 2014 to January 2015 (N = 864). The Adult ADHD Self‐Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior. Results After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose–response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD‐10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder, ADHD symptoms were significantly linked to all forms of suicidal behavior. Conclusion ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior. |
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| Keywords: | attempted suicide attention‐deficit/hyperactivity disorder Japan outpatients suicidal ideation |
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