Tuesday, 24 April 2018

Suicide risk in ADHD (based on a selective review)

The paper by Giancarlo Giupponi and colleagues [1] makes for pretty sombre reading in relation to the question of suicide risk in attention-deficit hyperactivity disorder (ADHD). Accepting that there were methodological differences among the various peer-reviewed studies included for [selective] review, authors' findings were along similar lines to what has previously been reported: "many studies indicate an association between ADHD and suicidal behavior."

I'm not going to say too much about the Giupponi findings on this blogging occasion, because they kinda speak for themselves. As well as covering quite a bit of research talking about suicidal behaviour in the context of child/adolescent and adult ADHD and the issue of "whether there is a direct relationship or whether the association depends on the increased prevalence of pre-existing comorbid conditions and individual and family dysfunctional factors", authors also mention the important role played by various medicines clinically indicated for ADHD as potentially being protective against suicidal behaviour(s) (see here). From a methodological perspective, I would have liked to have seen a table or something illustrating all the studies included in the Giupponi 'selective review' but oh-um...

The authors conclude by recommending that "patients with ADHD should be routinely screened for suicidal behavior, and early intervention protocols should be established in order to detect and reduce suicidal ideation and behavior and to improve the quality of life." I don't think anyone would disagree with such sentiments, added to what is already becoming known about suicidal behaviour in a more general context (see here). Given also the increasingly close proximity of ADHD to another label / conditions / diagnosis frequently discussed on this blog (see here) also including some enhanced suicide risk too (see here), I daresay that routine screening might extend much further than some might realise...

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[1] Giupponi G. et al. Suicide risk in attention-deficit/hyperactivity disorder. Psychiatr Danub. 2018 Mar;30(1):2-10.

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