Rother Yvette, Orlando Carissa M, Warren Peter, Flory Kate
Department of Psychology, University of South Carolina, Barnwell College, 1512 Pendleton Street, Columbia, SC, 29208, USA.
Clin Child Fam Psychol Rev. 2025 Jun 19. doi: 10.1007/s10567-025-00531-9.
In the United States, suicide is the second leading cause of death for those aged 10-14 and the third for those aged 15-24. Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at an increased risk for suicide compared to adolescents without ADHD. However, the strength of the relation between ADHD and suicide and the mechanisms at play in this association are unclear and need further investigation. This systematic review examined the literature to determine whether there is a direct association between ADHD and suicidality in adolescents, and which factors moderate or mediate this relation. A systematic literature search, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was carried out on December 20th, 2024. Relevant publications were identified via electronic searches of PsycInfo and Web of Science databases. Studies were included if they assessed ADHD, suicidality, and at least one additional construct analyzed as a moderator or mediator. Studies had to include participants with a mean age between 10 and 19 years (i.e., an adolescent sample). The literature search yielded 405 articles, with 28 included in the final study selection. ADHD emerged as an independent risk factor for suicide among adolescents. Various constructs, including psychological, demographic, family, peer and social, subjective well-being, and trauma and adversity factors, served as moderators or mediators to varying degrees. Our review can inform adolescent suicide prevention efforts by highlighting the importance of addressing specific risk factors. Further research is needed to examine understudied factors, with emphasis on strengths-based factors to improve well-being.
在美国，自杀是10至14岁人群的第二大死因，是15至24岁人群的第三大死因。与没有注意力缺陷多动障碍（ADHD）的青少年相比，患有ADHD的青少年自杀风险更高。然而，ADHD与自杀之间关系的强度以及这种关联中起作用的机制尚不清楚，需要进一步研究。本系统评价通过查阅文献，以确定ADHD与青少年自杀倾向之间是否存在直接关联，以及哪些因素调节或介导了这种关系。2024年12月20日，我们按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了系统的文献检索。通过对PsycInfo和Web of Science数据库进行电子检索，确定了相关出版物。如果研究评估了ADHD、自杀倾向，以及至少一个作为调节因素或中介因素分析的其他结构，则纳入该研究。研究必须纳入平均年龄在10至19岁之间的参与者（即青少年样本）。文献检索共获得405篇文章，最终纳入28项研究。ADHD是青少年自杀的一个独立危险因素。各种结构，包括心理、人口统计学、家庭、同伴和社会、主观幸福感以及创伤和逆境因素，在不同程度上起到了调节或中介作用。我们的综述通过强调解决特定风险因素的重要性，可为青少年自杀预防工作提供参考。需要进一步研究来考察研究较少的因素，重点是基于优势的因素以改善幸福感。
