Factors Associated with Suicide Attempts in Adults with ADHD: Findings from a Clinical Study

Abstract

Background and Objectives: Suicidality in adults with Attention-Deficit/Hyperactivity Disorder (ADHD) is an emerging clinical concern, yet its mechanisms and risk factors are not fully understood. Specifically, little is known about the characteristics of suicide attempts (SAs), including the use of violent/nonviolent methods. This study aimed to investigate the prevalence and methods of SA in adults with ADHD and to identify associated sociodemographic and clinical factors. Materials and Methods: The sample included 211 adult outpatients with ADHD. Patients were grouped based on the presence/absence of a lifetime SA. Among attempters, those who used a violent method (e.g., hanging, shooting, or jumping from a height) were compared with those who used a nonviolent method (e.g., poisoning). Statistical analyses included χ² tests, Kruskal-Wallis tests, and logistic regression. Results: In total, 9.9% (n = 21; 95% CI: 4.5-10.4) of participants reported a lifetime SA, with 23.8% (n = 5; 95% CI: 4.8-41.9) using violent methods. SA was significantly associated with comorbid personality disorders (p = 0.006, OR: 6.613, 95% CI: 0.537-5.812) and a higher number of hospitalizations (p = 0.008, OR: 1.980, 95% CI: 0.296-2.675). Nonviolent methods were linked to low self-esteem (p = 0.008). No significant associations with ADHD features or other psychiatric comorbidities emerged. Conclusions: Adults with ADHD are at risk for SA, showing patterns similar to other psychiatric populations. Unlike suicidal ideation, which has been directly linked to ADHD in previous studies, the transition to an SA appeared to be associated with comorbid personality disorders.

Keywords: Attention-Deficit/Hyperactivity Disorder (ADHD); attempt methods; personality disorder comorbidity; psychiatric hospitalization; sociodemographic determinants; suicide attempt (SA).

Figure 1

Recruitment process of the sample (n = 211).