@article{ref1,
title="Risk of suicide attempts in adolescents and young adults with attention-deficit hyperactivity disorder: a nationwide longitudinal study",
journal="British journal of psychiatry",
year="2018",
author="Huang, Kai-Lin and Wei, Han-Ting and Hsu, Ju-Wei and Bai, Ya-Mei and Su, Tung-Ping and Li, Cheng-Ta and Lin, Wei-Chen and Tsai, Shih-Jen and Chang, Wen-Han and Chen, Tzeng-Ji and Chen, Mu-Hong",
volume="212",
number="4",
pages="234-238",
abstract="BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) increases the risk of suicidal behaviours through psychiatric comorbidities; however, a significant direct association has not been observed between ADHD and suicide attempts. Aims To evaluate the risk of suicide attempt in adolescents and young adults with ADHD. <br><br>METHOD: Using a nationwide, population-based insurance claims database, this longitudinal cohort study enrolled 20 574 adolescents and young adults with ADHD and 61 722 age- and gender-matched controls between 2001 and 2009. Any suicide attempt was identified from enrolment to 31 December 2011. The association between ADHD medications and the likelihood of suicide attempt was assessed. <br><br>RESULTS: ADHD was an independent risk factor for any suicide attempt (hazard ratio = 3.84, 95% CI = 3.19-4.62) and repeated suicide attempts (hazard ratio = 6.52, 95% CI = 4.46-9.53). Subgroup analyses of men, women, adolescents and young adults demonstrated the same trend. Methylphenidate or atomoxetine treatment did not increase the risk of suicide attempt or repeated suicide attempts. Long-term methylphenidate treatment was associated with a significantly decreased risk of repeated suicide attempts in men (hazard ratio = 0.46, 95% CI = 0.22-0.97). <br><br>CONCLUSION: ADHD was a risk factor for suicide attempt and a stronger predictor of repeated suicide attempts, independent of comorbidities. Further investigation is warranted to explore the mechanism underlying the association between ADHD and suicidal behaviours. Declaration of interest None.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.2018.8",
url="http://dx.doi.org/10.1192/bjp.2018.8"
}