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Living on the edge: a review on potential risk factors for suicide in adult attention-deficit/hyperactivity disorder

Published online by Cambridge University Press:  01 September 2022

J. Miranda*
Affiliation:
Centro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, Portugal
M. Barbosa
Affiliation:
Centro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, Portugal
A. Tarelho
Affiliation:
Centro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, Portugal
R. Guedes
Affiliation:
Centro Hospitalar de Leiria, Department Of Mental Health And Psychiatry, Leiria, Portugal
*
*Corresponding author.

Abstract

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Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms including inattention, hyperactivity and/or impulsivity that commonly persists into adulthood. Suicide is a major cause of death in adult ADHD (aADHD) patients. Suicidality is higher in these patients, in possible relationship to various clinical and socio-demographic factors.

Objectives

To review the current literature concerning potential risk factors for suicide in aADHD patients.

Methods

A research was made using the Medline database through the Pubmed search engine, with the following keywords: “adhd”, “suicide”, “risk factors”.

Results

Comorbid psychiatric disorders (major depressive disorder, sleep disturbances, behavior disorders and addictive disorders) are powerful predictors of suicidal behavior in aADHD. Depression is the most frequent diagnosis among aADHD patients with previous suicide attempts. Subtype (mostly the combined type) and severity of ADHD were also associated with a higher number of prior suicide attempts. Impulsiveness, poor emotional self-regulation, recklessness, persistent hyperactivity, inability to relax, engagement in risk behavior (often found in ADHD), common personality traits in aADHD like low frustration tolerance, maladaptive coping and poor problem-solving, as well as interpersonal relationship problems, were associated with higher suicidality. Financial distress caused by unemployment is associated with higher suicidal behaviors. The suicidality is higher in females, mostly associated to self-concept, whereas in males is typically related to impulsivity.

Conclusions

Clinicians should be aware of the potential risk factors for suicide in aADHD patients because the early detection of these factors is fundamental to improve the patients’ quality of life and could contribute to the design of more effective treatments.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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