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Possible association between attention deficit hyperactivity disorder and attempted suicide in adolescents – A pilot study

Published online by Cambridge University Press:  16 April 2020

I. Manor
Affiliation:
Geha Mental Health Center, P.O. Box 102, 49100Petach Tikva, Israel Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
I. Gutnik
Affiliation:
Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Tirat Hacarmel Mental Health Center, Tirat Hacarmel, Israel
D.H. Ben-Dor
Affiliation:
Geha Mental Health Center, P.O. Box 102, 49100Petach Tikva, Israel
A. Apter
Affiliation:
Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Shneider Chidren's Hospital, Petach Tikva, Israel
J. Sever
Affiliation:
Geha Mental Health Center, P.O. Box 102, 49100Petach Tikva, Israel
S. Tyano
Affiliation:
Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
A. Weizman
Affiliation:
Geha Mental Health Center, P.O. Box 102, 49100Petach Tikva, Israel Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel-Aviv University, Petach Tikva, Israel
G. Zalsman*
Affiliation:
Geha Mental Health Center, P.O. Box 102, 49100Petach Tikva, Israel Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Neuroscience Division, Department of Psychiatry, Columbia University, New York, USA
*
*Corresponding author. Tel.: +972-3-925-8206; fax: +972-3-924-1041. E-mail address: gzalsman@clalit.org.il (G. Zalsman).
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Abstract

Objective

Both adolescent suicide and attention deficit hyperactivity disorder (ADHD) are troubling phenomena with high comorbidity, including impulsivity, depression and personality disorders (PD). Studies on the association between these two phenomena are relatively rare. This pilot study's aim was to estimate the rate of ADHD in adolescents attempting suicide.

Method

Subjects constituted consecutive admissions to the psychiatric emergency room (ER) who were admitted as a result of attempting suicide. Assessment included the use of the Kiddie-SADS, Strengths and Difficulties Questionnaire (SDQ) and the Conners’ Rating Scale (CRS). Those diagnosed as suffering from ADHD were assessed by a standardized Continuous Performance Test (Test of Variables of Attention [TOVA]) that included methylphenidate (MPH) challenge. Twenty-three (23) adolescents completed the study. M:F ratio was 5:18, respectively.

Results

Of the 23 participants who completed the study, 65% were diagnosed with ADHD, 43.5% with depression and 39% with cluster B PD. ADD/ADHD ratio was 66%:34%. Only five of the patients were formerly diagnosed as ADHD, only three had been medicated and 14 out of 15 adolescents responded well to MPH challenge.

Conclusion

These preliminary results suggest a significant association between ADHD and suicidal behavior in adolescents. Further study is needed to establish this association and assess the causality.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2009

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References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association Press; 2000.Google Scholar
Arnold, LESex differences in ADHD: conference summary. J Abnorm Child Psychol 1996;24:555569.CrossRefGoogle ScholarPubMed
Biederman, J, Spencer, T, Wilens, TEvidence-based pharmacotherapy for attention-deficit hyperactivity disorder. Int J Neuropsychopharmacol 2004;7:7797.CrossRefGoogle ScholarPubMed
Biederman, J, Ball, SW, Monuteaux, MC, Mick, E, Spencer, TJ, McCreary, Met al.New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 2008;47:426434.CrossRefGoogle ScholarPubMed
Brezo, J, Paris, J, Turecki, GPersonality traits as correlates of suicidal ideation, suicide attempts and suicide completions: a systematic review. Acta Psychiatr Scand 2006;113:180206.CrossRefGoogle ScholarPubMed
Cavanagh, JT, Carson, AJ, Sharpe, M, Lawrie, SMPsychological autopsy studies of suicide: a systematic review. Psychol Med 2003;33:395405.CrossRefGoogle ScholarPubMed
Cho, SC, Kim, JW, Choi, HJ, Kim, BN, Shin, MS, Lee, JHet al.Associations between symptoms of attention deficit hyperactivity disorder, depression and suicide in Korean female adolescents. Depress Anxiety 2007;25:E142E146.CrossRefGoogle Scholar
Conners, CKRating scales in attention-deficit/hyperactivity disorder: use in assessment and treatment monitoring. J Clin Psychiatry 1998;59(Suppl. 7):2430.Google ScholarPubMed
Forbes, GBClinical utility of the Test of Variables of Attention (TOVA) in the diagnosis of attention-deficit/hyperactivity disorder. J Clin Psychol 1998;54:461476.3.0.CO;2-Q>CrossRefGoogle Scholar
Fulwiler, C, Forbes, C, Santangelo, SL, Folstein, MSelf-mutilation and suicide attempt: distinguishing features in prisoners. J Am Acad Psychiatry Law 1997;25:6977.Google ScholarPubMed
Goodman, RThe Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997;38:581586.CrossRefGoogle ScholarPubMed
Goodman, RThe extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999;40:791799.CrossRefGoogle ScholarPubMed
Goodman, R, Meltzer, H, Bailey, VThe Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 1998;7:125130.CrossRefGoogle ScholarPubMed
Greenberg, LM, Waldman, IDDevelopmental normative data on the test of variables of attention (TOVA). J Child Psychol Psychiatry 1993;34:10191030.CrossRefGoogle Scholar
Hacker, KA, Suglia, SF, Fried, LE, Rappaport, N, Cabral, HDevelopmental differences in risk factors for suicide attempts between ninth and eleventh graders. Suicide Life Threat Behav 2006;36:154166.CrossRefGoogle ScholarPubMed
Horesh, N, Orbach, I, Gothelf, D, Efrati, M, Apter, AComparison of the suicidal behavior of adolescent inpatients with borderline personality disorder and major depression. J Nerv Ment Dis 2003;191:582588.CrossRefGoogle ScholarPubMed
James, A, Lai, FH, Dahl, CAttention deficit hyperactivity disorder and suicide: a review of possible associations. Acta Psychiatr Scand 2004;110:408415.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, Pet al.Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980988.CrossRefGoogle ScholarPubMed
Kelly, TM, Cornelius, JR, Clark, DBPsychiatric disorders and attempted suicide among adolescents with substance use disorders. Drug Alcohol Depend 2004;73:8797.CrossRefGoogle ScholarPubMed
Lowe, GA, Gibson, RCDepression in adolescence: new developments. West Indian Med J 2005;54:387391.CrossRefGoogle ScholarPubMed
Lowenstein, LFYouths who intentionally practise self-harm. Review of the recent research 2001–2004. Int J Adolesc Med Health 2005;17:225230.CrossRefGoogle ScholarPubMed
Murphy, KR, Barkley, RA, Bush, TYoung adults with attention deficit hyperactivity disorder: subtype differences in comorbidity, educational and clinical history. J Nerv Ment Dis 2002;190:147157.CrossRefGoogle ScholarPubMed
Nasser, EH, Overholser, JCAssessing varying degrees of lethality in depressed adolescent suicide attempters. Acta Psychiatr Scand 1999;99:423431.CrossRefGoogle ScholarPubMed
Paternite, CE, Loney, J, Salisbury, H, Whaley, MAChildhood inattention-overactivity, aggression and stimulant medication history as predictors of young adult outcomes. J Child Adolesc Psychopharmacol 1999;9:169184.CrossRefGoogle ScholarPubMed
Pompili, M, Ruberto, A, Girardi, P, Tatarelli, RSuicidality in DSM IV cluster B personality disorders. An overview. Ann Ist Super Sanita 2004;40:475483.Google ScholarPubMed
Rosenthal, PA, Rosenthal, SSuicidal behavior by preschool children. Am J Psychiatry 1984;141:520525.Google ScholarPubMed
Safer, DJA comparison of studies from the United States and Western Europe on psychiatric hospitalization referrals for youths exhibiting suicidal behavior. Ann Clin Psychiatry 1996;8:161168.CrossRefGoogle ScholarPubMed
Wilens, TE, Biederman, J, Spencer, TJAttention deficit/hyperactivity disorder across the lifespan. Annu Rev Med 2002;53:113131.CrossRefGoogle ScholarPubMed
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