Zahid Shaheer, Bodicherla Krishna Priya, Eskander Noha, Patel Rikinkumar S
Psychiatry, Saint James School of Medicine, Park Ridge, USA.
Psychiatry, Sri Devaraj Urs Medical College, Kolar, IND.
Cureus. 2020 May 4;12(5):e7949. doi: 10.7759/cureus.7949.
Objectives We conducted a cross-sectional study to understand the differences in demographics and psychiatric comorbidities in adolescents with major depressive disorder (MDD) and assess the risk of suicidality due to comorbid attention-deficit/hyperactivity disorder (ADHD). Methods We included 141,530 adolescents (age, 12 to 18 years) with a primary diagnosis of MDD from the nationwide inpatient sample (NIS, 2012-2014), and grouped by a comorbid diagnosis of ADHD (N = 22,665, 16%). Logistic regression analysis was used to measure the demographic predictors for ADHD in adolescents with MDD, and to measure the suicidal risk in ADHD versus non-ADHD. Results Comorbid ADHD was prevalent in whites (71.9%), and males had two times higher odds (95% CI 2.25-2.41) compared to females. The most prevalent comorbidities seen in ADHD-cohort were anxiety disorders (46.3%) and substance abuse (20.1%) with 1.3 times higher odds of substance abuse (95% CI 1.41-1.65) compared to non-ADHD. Suicidal behaviors were seen in a higher proportion of the ADHD cohort compared to the non-ADHD cohort (54.3% vs. 52.7%). ADHD and suicidal behaviors relationship was statistically significant but had a very small positive association (OR 1.04, 95% CI 1.01-1.08) after controlling for demographic confounders and comorbidities. There was a significant increase in the number of MDD hospitalization with ADHD for suicidal behaviors from 51.1% (N = 3,360) in 2012 to 58.2% (N = 5,115) in 2014. Conclusion There exists a significant but small positive association between suicidal behaviors and comorbid ADHD in MDD adolescents. The suicide rate has increased by 52.2% during the study period in depressed adolescents with ADHD. This calls for early diagnosis and management of ADHD and early-onset depression in adolescents to prevent suicide risk.
我们开展了一项横断面研究，以了解重度抑郁症（MDD）青少年在人口统计学和精神疾病共病方面的差异，并评估注意力缺陷多动障碍（ADHD）共病导致自杀的风险。方法：我们纳入了全国住院患者样本（2012 - 2014年）中141,530名初诊为MDD的青少年（年龄12至18岁），并根据ADHD共病诊断进行分组（N = 22,665，占16%）。采用逻辑回归分析来衡量MDD青少年中ADHD的人口统计学预测因素，并衡量ADHD组与非ADHD组的自杀风险。结果：ADHD共病在白人中较为普遍（71.9%），男性患ADHD的几率是女性的两倍（95%置信区间2.25 - 2.41）。ADHD组中最常见的共病是焦虑症（46.3%）和药物滥用（20.1%），与非ADHD组相比，药物滥用的几率高出1.3倍（95%置信区间1.41 - 1.65）。与非ADHD组相比，ADHD组中出现自杀行为的比例更高（54.3%对52.7%）。在控制了人口统计学混杂因素和共病后，ADHD与自杀行为之间的关系具有统计学意义，但呈非常小的正相关（比值比1.04，95%置信区间1.01 - 1.08）。因自杀行为而住院的MDD合并ADHD患者数量从2012年的51.1%（N = 3,360）显著增加到2014年的58.2%（N = 5,115）。结论：MDD青少年的自杀行为与ADHD共病之间存在显著但微弱的正相关。在研究期间，患有ADHD的抑郁青少年的自杀率上升了52.2%。这就要求对青少年的ADHD和早发性抑郁症进行早期诊断和管理，以预防自杀风险。
