Possible association between attention deficit hyperactivity disorder and attempted suicide in adolescents - a pilot study.
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.


METHODS
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.


CONCLUSIONS
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.
Manor
I
I
Geha Mental Health Center, P.O. Box 102, 49100 Petach Tikva, Israel.
Gutnik
I
I
Ben-Dor
D H
DH
Apter
A
A
Sever
J
J
Tyano
S
S
Weizman
A
A
Zalsman
G
G
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008403:Mass Screening; D008774:Methylphenidate / Q000627:therapeutic use; D009483:Neuropsychological Tests; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory; D010865:Pilot Projects; D012008:Recurrence; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*
D000697:Central Nervous System Stimulants; D008774:Methylphenidate