Suicide Ideation and Attempts are Associated with Co-occurring Oppositional Defiant Disorder and Sadness in Children and Adolescents with ADHD

Mothers rated the frequency of suicide ideation and attempts in 925 children and adolescents with ADHD (3-16 years). Ideation and attempts were more than twice as common in ADHD-Combined type than in ADHD-Inattentive type. Ideation occurred in 19 % with ADHD-C and in 7 % with ADHD-I. Percentages for attempts were 7 % and 3 %. For children and adolescents with co-occurring sadness and oppositional defiant disorder (ODD), 46 % had ideation and 21 % had attempts (vs. 6 and 2 % for ADHD alone). For those with ideation, 78 % had ODD or sadness. For those with attempts, 84 % had ODD or sadness. Maternal ratings of aggressive, explosive, sad, and moody were significant independent predictors of suicide behavior for ADHD-C, and sad and moody were predictors for ADHD-I. All children and adolescents with ADHD should be screened for suicide ideation and attempts, and co-occurring ODD and sadness should be treated to prevent suicide behavior.