Longitudinal Suicide Risk in Children and Adolescents With Attention Deficit and Hyperactivity Disorder: A Systematic Review and Meta-Analysis

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2025-06-18 DOI:10.1002/brb3.70618

Peter Garas, Zsofia K. Takacs, Judit Balázs

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Abstract

Background/Aims

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders among young people and significantly affects their quality of life. Previous research suggests an increased risk of suicidal behavior among individuals with ADHD; however, this has not yet been investigated in a meta-analysis of long-term studies. The primary aim of this study was to conduct an updated systematic review of longitudinal studies on ADHD and suicidality supplemented by meta-analytic calculations.

Methods

A systematic search was conducted across the following databases: OVID Medline, OVID PsychInfo, PubMed, Scopus, and Web of Science. Only longitudinal studies were included, in which most participants were under 18 years of age at baseline, had a clinical ADHD diagnosis, and provided sufficient data about suicidal behavior.

Results

In total, nine studies were included in both the meta-analysis and narrative review. The average odds ratios were significant and small to moderate in size for the following aspects: overall suicidality (OR = 3.336, 95% CI: 2.201; 5.057, p < 0.001), suicidal ideation (OR = 3.956, 95% CI: 1.996; 7.841, p < 0.001), suicide attempt (OR = 3.344, 95% CI: 1.682; 6.650, p = 0.001), and death (OR = 3.891, 95% CI: 2.103; 7.198, p < 0.001). The number of participants with ADHD ranged from 104 to 86,670, with a mean age between 5.2 and 14.94 years old, and the majority were male. Suicide behavior was more common in the ADHD combined subtype and the hyperactive/impulsive subtype. There are conflicting results regarding sex differences and the role of comorbidities.

Conclusions

The current systematic review and meta-analysis confirms previous findings that individuals with ADHD are at an elevated risk for suicidal behavior. However, this relationship is heterogeneous and complex, with significant differences across ADHD subtypes, age groups, sexes, comorbidities, and social issues, all of which play important roles in the development of suicidal behavior.

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患有注意缺陷和多动障碍的儿童和青少年的纵向自杀风险：一项系统回顾和荟萃分析

背景/目的注意缺陷多动障碍（ADHD）是青少年中最常见的精神障碍之一，严重影响他们的生活质量。先前的研究表明，患有多动症的人自杀行为的风险增加；然而，这还没有在长期研究的荟萃分析中进行调查。本研究的主要目的是对ADHD和自杀的纵向研究进行更新的系统回顾，并辅以meta分析计算。方法系统检索OVID Medline、OVID PsychInfo、PubMed、Scopus、Web of Science等数据库。仅包括纵向研究，其中大多数参与者基线年龄在18岁以下，有临床ADHD诊断，并提供有关自杀行为的足够数据。结果meta分析和叙述性综述共纳入9项研究。以下方面的平均优势比显著且从小到中等：总体自杀率(OR = 3.336, 95% CI: 2.201；5.057, p <；0.001)、自杀意念(OR = 3.956, 95% CI: 1.996；7.841, p <；0.001)，自杀企图(OR = 3.344, 95% CI: 1.682；6.650, p = 0.001)和死亡(OR = 3.891, 95% CI: 2.103；7.98, p <；0.001)。参与研究的ADHD患者人数从104人到86670人不等，平均年龄在5.2岁到14.94岁之间，大多数为男性。自杀行为在ADHD合并亚型和多动/冲动亚型中更为常见。关于性别差异和合并症的作用有相互矛盾的结果。目前的系统回顾和荟萃分析证实了先前的发现，即ADHD患者自杀行为的风险较高。然而，这种关系是异质性和复杂的，在ADHD亚型、年龄组、性别、合并症和社会问题之间存在显著差异，所有这些都在自杀行为的发展中起着重要作用。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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