Suicide is the second leading cause of death among people aged 15-24 years in Europe. Several studies showed that more than 90% of youth with suicidality have at least one concurrent psychiatric disorder. Recently there is a growing interest in attention-deficit/hyperactivity disorder (ADHD) as a risk factor of suicide. However, the results are controversial: the main question is whether there is a direct association between ADHD and suicidality or ADHD increases the risk of suicide by increasing the prevalence of comorbid conditions.

The aim of the present study was to examine whether there is a direct association between ADHD and suicidality.

Treatment naïve children (n=418, aged <18 years) were enrolled in the Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. The modified Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid) was used to evaluate psychiatric diagnosis and suicidality. Multiple mediation analyses were applied in a moderated mediational model.

ADHD and current suicidality were fully mediated by the symptoms of comorbid conditions. Significant mediators were: 1) under 12 years: the symptoms of specific anxiety disorders, 2) above age 12: symptoms of major depressive episode, dysthymia and substance use.

The study was cross-sectional.

Our findings are consistent with those previous studies which stated that ADHD symptoms are associated with an increased risk of suicidality. The current study highlights that with the consideration of developmental factors early recognition and combined treatment of the symptoms of ADHD and also comorbid conditions can be important in suicide prevention.