Link between ADHD and suicide in young people

What's the issue?

Emerging evidence suggests that people living with attention-deficit/hyperactivity disorder (ADHD) may have a greater risk of experiencing suicidal thoughts and behaviours, self-harm, and suicide compared to neuro-typical individuals.

ADHD is characterised by symptoms of inattention, impulsivity and hyperactivity, and it is among the most common mental disorders in children, often persisting into adulthood.

Children and adults living with ADHD may experience social isolation and difficulties in maintaining social relationships, which can impact their psychological wellbeing and increase the risk of depression or anxiety.

Impulsivity, a common trait of ADHD, is recognised as a contributing factor to suicidal behaviours, potentially placing individuals with ADHD at increased risk.

While previous research has predominantly focused on the relationship between ADHD and suicidal thoughts and behaviours in adults, the researchers of this study aimed to investigate this relationship among children in Australia.

What was done?

• Researchers used data from the Longitudinal Study of Australian Children (LSAC) that comprised 5107 children who had been followed up biennially since birth.
• 3696 of the 5107 were used as the cohort for the study, with 133 (3.6%) having an ADHD diagnosis.
• ADHD diagnosis was based on parental reports when their child was 10 years old.
• Suicide and self-harm data was provided by the children in the study which was defined as the child experiencing any suicidal thoughts or attempts over the past year when children were aged 14.
• Other factors that were examined included gender, socioeconomic status, birth weight, ADHD medication history, maternal education level, maternal age at birth, experience in bullying victimisation at age 12, and depression score based on Short Mood and Feelings Questionnaire at age 12.

What was found?

The study examined the relationship between ADHD diagnosis and suicide and self-harm, whist examining the impacts of co-occurring factors listed above.

Results showed that:

• Children who had a diagnosis of ADHD at age 10 were 11.3 times more likely to have experienced a suicidal thought, attempt, or plan by age 14 regardless of other cooccurring factors.
• Children who had a diagnosis of ADHD at age 10 were 25.14 times more likely to have engaged in self-harm by age 14.
• The influence of ADHD on suicidal thoughts, behaviours, suicide attempts and self-harm was more significant for boys.
• Experience of depression and exposure to bullying were a driver for the relationship between ADHD and suicide.
• Socioeconomic status, birth weight, maternal education level, and maternal age at birth were not significantly associated with an increased risk of suicidal thoughts and behaviours, suicide attempts, or self-harm at age 14.

The researchers suggest that the symptoms associated with ADHD could exacerbate depression, exposure to bullying, and distress in affected individuals. Consequently, these factors may increase feelings of hopelessness, thus elevating a child’s vulnerability to suicidal thoughts and behaviours.

Suicide risk may also be increased by factors such as impulsivity, limited coping skills, and social isolation often associated with an ADHD diagnosis.

Researchers also observed that in males, the risk of suicide may be increased by heightened tendencies towards physical aggression and other externalising behaviours linked to ADHD.

Why are the findings important?

Understanding the relationship between ADHD, suicide and other co-occurring factors can inform the development of targeted prevention strategies and support mechanisms, especially for groups at a higher risk of suicide, including those living with ADHD.

The study shows that children diagnosed with ADHD at age 10 have an elevated risk of experiencing suicidal thoughts, behaviours, attempts and self-harm, particularly among boys. Early screening and intervention for children living with ADHD could potentially mitigate suicide risk, with tailored approaches designed to address the specific needs of young males being particularly crucial.