Assessing suicidality in adult ADHD patients: prevalence and related factors : Suicidality in adult ADHD patients.

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2024-11-01 DOI:10.1186/s12991-024-00528-8
Gabriele Di Salvo, Camilla Perotti, Lorenzo Filippo, Camilla Garrone, Gianluca Rosso, Giuseppe Maina
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Abstract

Background: The association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients.

Methods: The sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB.

Results: The lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature.

Conclusions: Adults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD.

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评估成年多动症患者的自杀倾向:发病率及相关因素 :成人多动症患者的自杀倾向。
背景:近年来,注意力缺陷多动障碍(ADHD)与自杀之间的关系越来越受到研究人员的关注。对自杀倾向的评估通常是分类进行的,而且没有使用经过验证的工具,这导致了证据的不一致甚至相互矛盾。自杀意念和自杀未遂的发生率差异很大,相关的风险因素仍不清楚。我们的研究采用一种维度方法和一种经过验证的国际公认工具,对多动症患者的自杀倾向进行了调查。我们的主要目的是评估ADHD成年患者样本中自杀意念(SI)、严重自杀意念(SSI)、自杀行为(SB)和非自杀性自伤行为(NSSIB)的发生率。第二个目的是确定与这些患者自杀风险增加相关的社会人口学和临床特征:样本包括 74 名临床诊断为多动症的成年患者。自杀倾向通过哥伦比亚自杀严重程度评定量表进行评估。结果:SI、SSI、SB 和 NSSIB 的终生发生率分别为 0.5%、0.5%、0.5% 和 0.5%:SI和SSI的终生患病率分别为59.5%和16.2%。9.5%的患者终生存在SB,10.8%的受试者终生存在NSSIB。终生 SI 与成年后注意力不集中症状的严重程度、自卑和社会功能受损有关。终生SSI似乎与儿童期注意力不集中症状的严重程度、注意冲动和住院次数有关,而体育活动似乎具有保护作用。终生SB和NSSIB的患病率似乎与任何社会人口学或临床特征没有明显关系:结论:应将患有多动症的成年人视为有自杀风险的人群,重要的是要确定哪些患者有更高的自杀风险,以便为预防干预措施提供指导。ADHD与自杀意念之间的关联似乎不受精神疾病合并症的影响,而是受注意力不集中本身的影响,而注意力不集中正是ADHD的核心症状。
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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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