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注意缺陷多动障碍症状与自杀意念和自杀未遂:2007 年成人精神疾病调查研究结果。

Attention-deficit/hyperactivity disorder symptoms and suicide ideation and attempts: Findings from the Adult Psychiatric Morbidity Survey 2007.

机构信息

Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center for Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain.

出版信息

J Affect Disord. 2016 Jan 1;189:321-8. doi: 10.1016/j.jad.2015.09.061. Epub 2015 Oct 22.

Abstract

BACKGROUND

Adults with attention-deficit/hyperactivity disorder (ADHD) may have an increased risk of engaging in suicidal behavior. This study examined this association in the general adult population where there has been little research.

METHODS

Data came from the Adult Psychiatric Morbidity Survey 2007. This was a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) was used to obtain information on ADHD symptoms. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of common mental disorder (CMD). Information was also obtained on the lifetime and past 12-month occurrence of suicide ideation and attempts. Logistic regression analysis was used to examine these associations.

RESULTS

After adjusting for comorbid disorders, adults with more ADHD symptoms had significantly higher odds for suicidal behavior. When a single cut-off point was used to classify ADHD (ASRS score ≥14), odds ratios ranged from 1.62 (lifetime suicide attempt) to 2.43 (past 12-month suicide ideation). When ADHD symptoms were categorized by strata (I: a score of 0-9; II: 10-13; III: 14-17; IV: 18-24), compared to adults in stratum I, those in stratum IV had odds ratios ranging from 2.16 (lifetime suicide ideation) to 3.68 (past 12-month suicide attempt).

LIMITATIONS

ADHD and suicide data came from self-reports which may have been affected by socially desirable responding.

CONCLUSIONS

ADHD symptoms were linked to suicidal behavior after controlling for comorbid conditions. Health care professionals should be alerted to the increased suicide risk among adults with ADHD symptoms.

摘要

背景

患有注意力缺陷/多动障碍(ADHD)的成年人可能有更高的自杀行为风险。这项研究在一般成年人群体中研究了这种关联,而在这个群体中,相关研究很少。

方法

数据来自 2007 年成人精神病学发病率调查。这是一个具有代表性的年龄在 16 岁及以上的英国成年家庭人口样本(N=7403)。使用成人注意缺陷多动障碍自评量表(ASRS)获取 ADHD 症状信息。使用临床访谈表修订版(CIS-R)评估六种常见精神障碍(CMD)。还获取了一生中及过去 12 个月自杀意念和尝试的信息。使用逻辑回归分析来检查这些关联。

结果

在调整了共病障碍后,ADHD 症状较多的成年人自杀行为的可能性显著更高。当使用单一截断点来分类 ADHD(ASRS 评分≥14)时,比值比范围从 1.62(终生自杀尝试)到 2.43(过去 12 个月自杀意念)。当根据 ADHD 症状分层(I:得分 0-9;II:10-13;III:14-17;IV:18-24)时,与处于 I 层的成年人相比,处于 IV 层的成年人的比值比范围从 2.16(终生自杀意念)到 3.68(过去 12 个月自杀尝试)。

局限性

ADHD 和自杀数据来自于自我报告,可能受到社会期望反应的影响。

结论

在控制了共病情况后,ADHD 症状与自杀行为有关。医疗保健专业人员应注意到 ADHD 症状成年人的自杀风险增加。

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