title: Attention-deficit hyperactivity disorder and suicidality in a treatment naïve sample of children and adolescents.
abstract: BACKGROUND
  The aim of the present study was to investigate the possible association between attention-deficit/hyperactivity disorder (ADHD) and suicidality.
  
  
  METHODS
  Using a structured interview (Mini International Neuropsychiatric Interview Kid), the authors examined 418 treatment naïve children/adolescents (aged: 3-18 years). Suicidality was defined by the M.I.N.I. Kid as having any current suicidal ideations and/or suicide attempts.
  
  
  RESULTS
  Two hundred and eleven children/adolescents fulfilled the DSM-IV diagnosis of ADHD and a further 105 showed symptoms of ADHD in subthreshold level. Multiple mediation analyses resulted in a moderated meditational model in which the relationship between symptoms of ADHD and current suicidality was fully mediated by the symptoms of comorbid conditions, but this was moderated by age. In children under 12 years, significant mediators were the symptoms of specific anxiety disorders, while in the adolescent group symptoms of major depressive episode and dysthymia and symptoms of substance abuse/dependence approved as significant mediators.
  
  
  CONCLUSIONS
  As the study was cross-sectional, it did not reveal any causal relationship among the investigated factors. Furthermore, as the study population included a treatment naïve clinical sample, we can assume that adolescents, who and/or whose family seek for help at the first time in this age belonged to the less sever end of the spectrum.
  
  
  CONCLUSIONS
  ADHD symptoms are associated with an increased risk of suicidality in treatment naïve children/adolescents. The mechanisms of this relationship can be understood only when developmental factors are considered. Our findings suggest that clinicians should screen suicidality and comorbid symptoms routinely in patients with ADHD.
authors.affiliation: Eötvös Loránd University, Institute of Psychology, Budapest 1064, Hungary; Vadaskert Child and Adolescent Psychiatry Hospital, Budapest, Hungary. Electronic address: judit.agnes.balazs@gmail.com.
authors.forename: Judit
authors.initials: J
authors.lastname: Balazs
authors.forename: Mónika
authors.initials: M
authors.lastname: Miklósi
authors.forename: Agnes
authors.initials: A
authors.lastname: Keresztény
authors.forename: Gyöngyvér
authors.initials: G
authors.lastname: Dallos
authors.forename: Júlia
authors.initials: J
authors.lastname: Gádoros
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D012307:Risk Factors; D059020:Suicidal Ideation
keywords: ADHD; Clinical aspects; Comorbidity; Suicide