Women with Attention Deficit Hyperactivity Disorder are eight times more likely to attempt suicide, while men with ADHD are four and a half times more likely; parental violence and substance dependence increase the prevalence of suicide attempts

Attention Deficit Hyperactive Disorder (ADHD) can have negative consequences on mental health into adulthood. A nationally representative Canadian study reported that the lifetime prevalence of suicide attempts was much higher for women who had ADHD (24%) compared to women who had not (3%). Men with ADHD were also more likely to have attempted suicide compared to men without ADHD (9% vs. 2%).

“ADHD casts a very long shadow. Even when we took into account history of mental illness, and the higher levels of poverty and early adversities that adults with ADHD often experience, those with ADHD still had 56% higher odds of having attempted suicide than their peers without ADHD” reported lead author Esme Fuller-Thomson, Professor at University of Toronto’s Factor-Inwentash Faculty of Social Work and Director of the Institute for Life Course and Aging.

Because ADHD is more common among men than among women, little research or clinical attention has focused on women with the disorder. In this study, women with ADHD had more than twice the odds of suicide attempts compared to men with ADHD.

“Our finding that one in four Canadian women with ADHD had attempted suicide highlights the urgency of providing adequate mental health supports across the life course to this vulnerable and neglected group,” said Lauren Carrique, a recent graduate of University of Toronto’s Masters in Social Work (MSW) program who is a social worker at Toronto General Hospital.

Adults with ADHD who had been exposed to chronic parental domestic violence had triple the odds of suicide attempts compared to their peers with ADHD who had not experienced that childhood adversity. Parental domestic violence was defined as “chronic” if it had occurred more than 10 times before the respondent was age 16.

“The cross-sectional nature of this study prohibits our ability to determine possible causality; the relationship between chronic parental domestic violence and suicide attempts could flow in either direction,” stated co-author Raphaël Nahar Rivière, a medical resident in anesthesiology at the University of Toronto.

“We speculate that violent parental conflict may cause extreme stress for the child with ADHD and predispose these individuals to mental illness and suicidal thoughts. In addition, the challenges of raising a child with ADHD who is struggling with severe mental health issues may cause parental conflict, which may escalate into domestic violence.”

The study examined a nationally representative sample of 21,744 Canadians, of whom 529 reported they had been diagnosed with ADHD. Data were drawn from the Canadian Community Health Survey-Mental Health.

“The disturbingly high prevalence of suicide attempts among people with ADHD underline the importance of health professionals screening patients with ADHD for mental illness and suicidal thoughts,” said co-author Senyo Agbeyaka, a recent University of Toronto MSW graduate who is a social worker at University Health Network.

“Knowing that women with ADHD who have experienced childhood adversities and adults with a history of substance dependence and/or depression are particularly vulnerable to attempting suicide will hopefully help clinicians improve targeting and outreach to this population.”