Identifying the Symptom of Worthlessness to Prevent Suicide in Adolescents With ADHD

New research finds that clinicians should ask routine questions about feelings of worthlessness at initial and follow-up examinations of adolescent patients with attention-deficit/hyperactivity disorder (ADHD) to help prevent suicide.¹

“We identified worthlessness and disorganized path of depression as the primary contributor to suicidal thoughts and planning,” wrote the authors.1

Previous studies have found that ADHD, depression, and general anxiety disorder (GAD) are all strongly correlated with suicidal ideation. Specifically, adolescents with ADHD are at a higher risk of suicide than adolescents without ADHD.² The current study gathered 185 high school-aged children in Hungary, mean age of 14.79 years, with (N=89) and without (N=96) ADHD in order to assess the relationship between ADHD, depression, GAD, and worthlessness—a symptom experienced by 70% to 80% of patients with major depressive disorder.³ 

The Mini International Neuropsychiatric Interview for Children and Adolescents was used to evaluate psychiatric symptoms and disorders as well as suicidal thoughts and planning. Regularized psychological networks were used to investigate the associations. ADHD symptoms were significantly correlated with symptoms of depression (p = 0.3, p < 0.001) and of suicidal thoughts and planning (p = 0.17, p = 0.02), but not with anxiety (p = 0.12, p = 0.11). Suicidal thoughts and planning were significantly related to depression (p = 0.3, p < 0.001), but not to anxiety (p = 0.06, p = 0.42). Anxiety was significantly associated with only depression (p = 0.34, p < 0.001). Worthlessness was found to be directly related to suicidal ideation.

“The current study draws the attention of clinicians to the importance of screening suicidality among their patients with ADHD, with special focus on those who have comorbid depression and/or anxiety,” said the authors.¹

References

1. Katzenmajer-Pump L, Komároy D, Balázs J. The importance of recognizing worthlessness for suicide prevention in adolescents with attention-deficit/hyperactivity disorder. Front Psychiatry. 2022;13:969164.

2. Giupponi G, Giordano G, Maniscalco I, et al. Suicide risk in attention-deficit/hyperactivity disorder. Psychiatr Danub. 2018;30(1):2-10.

3. Buchwald AM, Rudick-Davis D. The symptoms of major depression. J Abnorm Psychol. 1993;102(2):197.