ADHD and Suicide Risk: The Overlooked Roles of Comorbid Disorders and Stimulant Medications.

Abstract

Does Attention Deficit Hyperactivity Disorder (ADHD) increase the risk of suicidality among children? This article critically examines a notable study by Shahnovsky et al. (2024), which identifies hyperactivity as a significant predictor of suicide attempts. A detailed analysis of the study reveals three critical gaps: (1) oversight of key risk factors, such as ADHD medications and comorbid disorders - some of which were examined in a related study by the same authors, showing no significant association between ADHD and suicidality; (2) misinterpretation of prior research, inaccurately presenting ADHD medications as protective despite evidence indicating a significantly elevated suicide risk among users; and (3) misrepresentation of the study's findings, which largely suggested that ADHD was unrelated to suicide risk based on both parent and child reports and the two examined components of ADHD. Drawing on an extensive body of research, it is argued that depressive symptoms and suicidal ideation are more likely attributable to the first-line treatments for ADHD than to the diagnosis itself. By situating the study within the broader literature, this article cautions against potential real-life implications arising from its conclusions, such as clinicians prescribing ADHD medications to suppress the allegedly dangerous hyperactivity - medications that may paradoxically increase the risk of suicide. This critique is offered with the utmost respect for the authors' lifelong dedication to advancing suicide prevention, with the sincere aim of fostering a constructive dialogue to deepen our understanding of the tragic phenomenon of childhood suicide.