Oh Yunhye, Kim Yangsik, Ryu Vin
Department of Psychiatry, Hallym Sacred Heart Hospital, Republic of Korea.
Department of Psychiatry, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.
Asian J Psychiatr. 2024 Dec;102:104277. doi: 10.1016/j.ajp.2024.104277. Epub 2024 Oct 20.
Recently, adult ADHD diagnoses have increased, complicating treatment when comorbid with other disorders. Subthreshold ADHD(sADHD) also poses challenges, especially with comorbidities and suicidality. This study explores psychiatric comorbidities' role in ADHD and sADHD suicidality.
We analyzed microdata from the National Mental Health Survey of Korea 2021 to examine the association of ADHD on comorbidities and suicide-related behaviors.
Of the 5511 participants, 194(3.52 %) were diagnosed with ADHD, and 775(14.1 %) had sADHD. In 12-month prevalence, suicidal ideation and plans were more prevalent in both ADHD and sADHD patients than in controls, with higher odds ratios(ADHD vs. control OR 12.87; suicidal ideation, 54.06; suicidal plan, sADHD vs control OR 8.26; suicidal ideation, 17.63; suicidal plans). Lifetime suicidal ideation and plans were notably associated with alcohol use disorder(OR 6.15 in ideation, 3.83; plan) and nicotine use disorder in participants with ADHD(OR 5.36 in ideation, 5.31; plan), whereas sADHD associations were found with alcohol use disorder(OR 1.80 in ideation) and depressive disorder(OR 1.90 in ideation) compared to the controls. Additionally, differences in suicidal behavior between sADHD and ADHD were identified for alcohol use disorder(OR 3.42 in ideation, 4.15; plan) and nicotine use disorder(OR 4.02 in ideation, 4.98 in plan).
These results indicated a heightened risk of psychiatric comorbidities and suicidal ideation or plans in the ADHD and sADHD groups. These results suggest the need for a more diverse focus on comprehensive mental health assessments and proactive support for patients with ADHD, regardless of symptom severity.
近年来，成人注意力缺陷多动障碍（ADHD）的诊断数量有所增加，这使得其与其他疾病共病时的治疗变得复杂。亚阈值ADHD（sADHD）也带来了挑战，尤其是在共病和自杀倾向方面。本研究探讨了精神共病在ADHD和sADHD自杀倾向中的作用。
我们分析了2021年韩国全国心理健康调查的微观数据，以研究ADHD与共病及自杀相关行为之间的关联。
在5511名参与者中，194人（3.52%）被诊断为ADHD，775人（14.1%）患有sADHD。在12个月患病率方面，ADHD和sADHD患者的自杀意念和自杀计划比对照组更为普遍，比值比更高（ADHD与对照组相比，自杀意念的比值比为12.87；自杀计划的比值比为54.06；sADHD与对照组相比，自杀意念的比值比为8.26；自杀计划的比值比为17.63）。终生自杀意念和自杀计划与ADHD参与者的酒精使用障碍（意念的比值比为6.15，计划的比值比为3.83）和尼古丁使用障碍显著相关（意念的比值比为5.36，计划的比值比为5.31），而与对照组相比，sADHD与酒精使用障碍（意念的比值比为1.80）和抑郁症（意念的比值比为1.90）有关联。此外，在酒精使用障碍（意念的比值比为3.42，计划的比值比为4.15）和尼古丁使用障碍（意念的比值比为4.02，计划的比值比为4.98）方面，发现sADHD和ADHD在自杀行为上存在差异。
这些结果表明，ADHD和sADHD组中精神共病以及自杀意念或自杀计划的风险增加。这些结果表明，无论症状严重程度如何，都需要更加多样化地关注对ADHD患者的全面心理健康评估和积极支持。
