Both Attention Deficit Hyperactivity Disorder (ADHD) and suicidal behaviour are common psychiatric conditions with significant social and emotional morbidity. Although completed suicide in ADHD has been assessed in a previous meta-analysis, other domains of suicidal behaviour such as attempts and ideation have been documented only in individual studies. This review provides a summary of these studies in order to examine the relationship between attention deficit and risk to self.

Electronic and manual literature search of MEDLINE, EMBASE and PSYCHINFO, using a range of search terms around suicidality, attention-deficit and hyperactivity. Articles included both those looking at diagnosis of ADHD in suicidal populations, and those looking at suicidality in pre-diagnosed ADHD populations.

Wide variation was seen in all dimensions, with the main determining factor being co-morbid diagnoses.

In populations completing suicide, ADHD was present in 4 to 25.9%. In suicide attempt and ideation populations, 1.6 to 65% and 10.5–31.8% respectively had ADHD. Attention deficit disorders were diagnosed more frequently in suicidal males than females. Age and location differences were not consistent across groups.

In those with diagnosed ADHD, 9.1–70% had attempted suicide and 15.8–66.3% described suicidal ideation. Higher rates were seen in prison inmates and drug dependent subjects.

Although there is a positive relationship between ADHD and risk to self, the magnitude can vary greatly between different populations. Further research on larger samples is necessary to firmly establish this. The process of risk assessment in ADHD needs to take into account the possibility of intentional self-injury and provide management strategies.