{"title":"Heightened suicidal risk in ADHD and subthreshold ADHD: Understanding the role of psychiatric comorbidities","authors":"Yunhye Oh , Yangsik Kim , Vin Ryu","doi":"10.1016/j.ajp.2024.104277","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Recently, adult ADHD diagnoses have increased, complicating treatment when comorbid with other disorders. Subthreshold ADHD(sADHD) also poses challenges, especially with comorbidities and suicidality. This study explores psychiatric comorbidities' role in ADHD and sADHD suicidality.</div></div><div><h3>Methods</h3><div>We analyzed microdata from the National Mental Health Survey of Korea 2021 to examine the association of ADHD on comorbidities and suicide-related behaviors.</div></div><div><h3>Results</h3><div>Of the 5511 participants, 194(3.52 %) were diagnosed with ADHD, and 775(14.1 %) had sADHD. In 12-month prevalence, suicidal ideation and plans were more prevalent in both ADHD and sADHD patients than in controls, with higher odds ratios(ADHD vs. control OR 12.87; suicidal ideation, 54.06; suicidal plan, sADHD vs control OR 8.26; suicidal ideation, 17.63; suicidal plans). Lifetime suicidal ideation and plans were notably associated with alcohol use disorder(OR 6.15 in ideation, 3.83; plan) and nicotine use disorder in participants with ADHD(OR 5.36 in ideation, 5.31; plan), whereas sADHD associations were found with alcohol use disorder(OR 1.80 in ideation) and depressive disorder(OR 1.90 in ideation) compared to the controls. Additionally, differences in suicidal behavior between sADHD and ADHD were identified for alcohol use disorder(OR 3.42 in ideation, 4.15; plan) and nicotine use disorder(OR 4.02 in ideation, 4.98 in plan).</div></div><div><h3>Conclusion</h3><div>These results indicated a heightened risk of psychiatric comorbidities and suicidal ideation or plans in the ADHD and sADHD groups. These results suggest the need for a more diverse focus on comprehensive mental health assessments and proactive support for patients with ADHD, regardless of symptom severity.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"102 ","pages":"Article 104277"},"PeriodicalIF":3.8000,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian journal of psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876201824003708","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
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Abstract
Objectives
Recently, adult ADHD diagnoses have increased, complicating treatment when comorbid with other disorders. Subthreshold ADHD(sADHD) also poses challenges, especially with comorbidities and suicidality. This study explores psychiatric comorbidities' role in ADHD and sADHD suicidality.
Methods
We analyzed microdata from the National Mental Health Survey of Korea 2021 to examine the association of ADHD on comorbidities and suicide-related behaviors.
Results
Of the 5511 participants, 194(3.52 %) were diagnosed with ADHD, and 775(14.1 %) had sADHD. In 12-month prevalence, suicidal ideation and plans were more prevalent in both ADHD and sADHD patients than in controls, with higher odds ratios(ADHD vs. control OR 12.87; suicidal ideation, 54.06; suicidal plan, sADHD vs control OR 8.26; suicidal ideation, 17.63; suicidal plans). Lifetime suicidal ideation and plans were notably associated with alcohol use disorder(OR 6.15 in ideation, 3.83; plan) and nicotine use disorder in participants with ADHD(OR 5.36 in ideation, 5.31; plan), whereas sADHD associations were found with alcohol use disorder(OR 1.80 in ideation) and depressive disorder(OR 1.90 in ideation) compared to the controls. Additionally, differences in suicidal behavior between sADHD and ADHD were identified for alcohol use disorder(OR 3.42 in ideation, 4.15; plan) and nicotine use disorder(OR 4.02 in ideation, 4.98 in plan).
Conclusion
These results indicated a heightened risk of psychiatric comorbidities and suicidal ideation or plans in the ADHD and sADHD groups. These results suggest the need for a more diverse focus on comprehensive mental health assessments and proactive support for patients with ADHD, regardless of symptom severity.
目的：最近，成人多动症（ADHD）的诊断有所增加，当合并其他疾病时，治疗会变得更加复杂。阈下多动症（sADHD）也带来了挑战，尤其是合并症和自杀。本研究探讨了精神科合并症在多动症和亚阈多动症自杀中的作用：我们分析了韩国 2021 年全国心理健康调查的微观数据，以研究多动症与合并症和自杀相关行为的关联：在 5511 名参与者中，194 人（3.52%）被诊断为多动症，775 人（14.1%）患有 sADHD。在 12 个月的患病率中，ADHD 和 sADHD 患者的自杀意念和自杀计划的发生率均高于对照组，其几率比（ADHD vs. 对照组 OR 12.87；自杀意念，54.06；自杀计划，sADHD vs. 对照组 OR 8.26；自杀意念，17.63；自杀计划）也更高。与对照组相比，ADHD 患者的终生自杀意念和计划与酗酒障碍（意念 OR 6.15，计划 OR 3.83）和尼古丁使用障碍（意念 OR 5.36，计划 OR 5.31）明显相关，而 SADHD 患者则与酗酒障碍（意念 OR 1.80）和抑郁障碍（意念 OR 1.90）相关。此外，在酒精使用障碍（意念中 OR 3.42，计划中 OR 4.15）和尼古丁使用障碍（意念中 OR 4.02，计划中 OR 4.98）方面，sADHD 和 ADHD 的自杀行为存在差异：这些结果表明，ADHD 和 sADHD 组合并精神疾病和有自杀意念或计划的风险较高。这些结果表明，无论症状严重程度如何，都有必要对多动症患者进行更全面的心理健康评估，并为其提供积极的支持。
期刊介绍：
The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.
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