Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway.
Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
BMC Psychiatry. 2024 Aug 19;24(1):564. doi: 10.1186/s12888-024-06008-3.
Adolescents with attention-deficit / hyperactivity disorder (ADHD) have an increased risk of self-harm. The risk of self-harm among adolescents who display an elevated level of ADHD symptoms, but without a formal diagnosis, is not well-studied and understood.
To investigate the relationship between self-reported symptoms of ADHD and self-harm in a population-based sample of adolescents.
Adolescents in the population-based youth@hordaland study were invited to complete the Adult ADHD Self-Report Scale (ASRS) and the Short Mood and Feelings Questionnaire (SMFQ). They were asked whether they ever deliberately have taken an overdose or tried to harm themselves on purpose, once or multiple times, defined according to the code used in the Child and Adolescent Self-harm in Europe (CASE) Study. Adolescents reporting severe problems on ≥ four of six selected items on the ASRS-v 1.1 screener were defined as ADHD-screen positive (ADHD-SC+), and the remaining sample as ADHD-screen negative (ADHD-SC-). SMFQ score ≥ 12 was used to define a high level of depressive symptoms.
A total of 9692 adolescents (mean age 17.4 years, 53.1% females) participated in the study, of which 2390 (24.7%) screened positive on the ASRS. ADHD-SC+ adolescents engaged in self-harm more often than the ADHD-SC- group (14.6% vs. 5.4%, OR = 3.02, 95%CI [2.57-3.24]). This remained significant after adjustment for demographic variables, SMFQ score ≥ 12, symptoms of conduct disorder and familial history of self-harm and suicide attempts (OR = 1.58, 95%CI [1.31-1.89]). They were also more likely to report an overdose as their method of self-harm (OR = 1.52, 95%CI [1.05-2.23]). Within the ADHD-SC+ group female sex, high levels of inattention and hyperactivity/impulsivity symptoms, SMFQ score ≥ 12, symptoms indicating conduct disorder and familial history of self-harm and suicide attempts increased the likelihood of engaging in deliberate self-harm.
Adolescents who screened positive for ADHD had increased risk of engaging in self-harm. Clinicians should consider the increased risk of such engagement in adolescents who present with high level of ADHD symptoms, even in the absence of a clinical ADHD diagnosis.
患有注意缺陷多动障碍（ADHD）的青少年自残的风险增加。在表现出 ADHD 症状升高但未正式诊断的青少年中，自残的风险尚未得到充分研究和了解。
在基于人群的青少年样本中调查自报 ADHD 症状与自残之间的关系。
邀请基于人群的青年@霍达兰研究中的青少年完成成人 ADHD 自我报告量表（ASRS）和短期情绪和感觉问卷（SMFQ）。他们被问到是否曾经故意过量服用或故意伤害自己，无论是一次还是多次，根据儿童和青少年在欧洲自我伤害（CASE）研究中使用的代码定义。在 ASRS-v1.1 筛选器上选择的六个项目中的四个或更多项目上报告严重问题的青少年被定义为 ADHD 筛查阳性（ADHD-SC+），其余样本为 ADHD 筛查阴性（ADHD-SC-）。SMFQ 评分≥12 用于定义高水平的抑郁症状。
共有 9692 名青少年（平均年龄 17.4 岁，女性占 53.1%）参加了这项研究，其中 2390 名（24.7%）ASRS 筛查阳性。ADHD-SC+青少年比 ADHD-SC-组更频繁地进行自残（14.6%对 5.4%，OR=3.02，95%CI [2.57-3.24]）。在调整人口统计学变量、SMFQ 评分≥12、品行障碍症状和自残及自杀未遂的家族史后，这一结果仍然显著（OR=1.58，95%CI [1.31-1.89]）。他们也更有可能报告过量服用作为自残的方法（OR=1.52，95%CI [1.05-2.23]）。在 ADHD-SC+组中，女性、高水平的注意力不集中和多动/冲动症状、SMFQ 评分≥12、提示品行障碍的症状和自残及自杀未遂的家族史增加了故意自残的可能性。
ADHD 筛查阳性的青少年自残风险增加。临床医生应考虑在出现高水平 ADHD 症状的青少年中增加这种风险，即使没有临床 ADHD 诊断也是如此。
