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Attention-deficit hyperactivity disorder increases the risk of deliberate self-poisoning: A population-based cohort

Published online by Cambridge University Press:  15 April 2020

I.-C. Chou ,
C.-C. Lin ,
F.-C. Sung  and
C.-H. Kao
I.-C. Chou
Affiliation:
Department of Pediatrics, China Medical University Hospital, China Medical University, Taichung, Taiwan Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
C.-C. Lin
Affiliation:
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
F.-C. Sung
Affiliation:
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
C.-H. Kao*
Affiliation:
Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
*
*Corresponding author. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan. Tel.: +886 4 2205 2121x7412; fax: +886 4 2233 6174. E-mail address: d10040@mail.cmuh.org.tw (C.-H. Kao).
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Abstract

Background

Children with attention-deficit hyperactivity disorder (ADHD) may suffer marked impairment in early adulthood, increasing their risk for serious self-harmful behaviors. Deliberate self-poisoning (DSP) is the most common form of deliberate self-harm. An association may exist between ADHD diagnosis and subsequent DSP events. The purpose of study was to determine whether children and adolescents with ADHD are at a greater risk for DSP than are age-matched controls.

Methods

Claims data from the Taiwan National Health Insurance Database were used to conduct a retrospective cohort analysis of emergency department visits. The study cohort contained 3685 patients with ADHD (< 8 years old). Each ADHD patient was frequency matched based on sex, age, urbanization, parental occupation, and index year to 10 control patients without ADHD. A Cox proportional-hazards regression model was used to estimate the risk of DSP in the ADHD and comparison cohorts.

Results

The risk of developing DSP was significantly higher in the ADHD cohort than in the comparison cohort (P < .0001 for log-rank test). After adjusting for potential confounders, the regression model showed that the ADHD patients were at a 4.65-fold greater risk of developing DSP than the control patients were (HR = 4.65, 95% CI: 2.41–8.94).

Conclusion

Children with ADHD are at greater risk of developing DSP. Identifying risk factors of DSP is crucial efforts to implement prevention strategies. The identification of the underlying cause of increased DSP among ADHD patients warrants further investigation.

Keywords

Attention-deficit hyperactivity disorderCohort studyDeliberate self-poisoning
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 8 , October 2014 , pp. 523 - 527
Copyright
Copyright © Elsevier Masson SAS 2014

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References

Ayton, A., Rasool, H., Cottrell, D.Deliberate self-harm in children and adolescents: association with social deprivation. Eur Child Adolesc Psychiatry 2003;12(6):303–307.CrossRefGoogle ScholarPubMed
Barkley, R.A., Murphy, K.R., Fischer, M.ADHD in adults: what the science says. New York: Guilford Press; 2008.Google Scholar
Cumyn, L., French, L., Hechtman, L.Comorbidity in adults with attention-deficit hyperactivity disorder. Can J Psychiatry 2009;54:673–683.CrossRefGoogle ScholarPubMed
Fletcher, J., Wolfe, B.Long-term consequences of childhood ADHD on criminal activities. J Ment Health Policy Econ 2009;12:119–138.Google ScholarPubMed
Froehlich, T.E., Lanphear, B.P., Epstein, J.N., Barbaresi, W.J., Katusic, S.K., Kahn, R.S.Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med 2007;161:857–864.CrossRefGoogle Scholar
Gunnell, D.J., Peters, T.J., Kammerling, R.M., Brooks, J.Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation. BMJ 1995;311:226–230.CrossRefGoogle ScholarPubMed
Gunnell, D., Shepherd, M., Evans, M.Are recent increases in deliberate self harm associated with changes in socioeconomic conditions? An ecological analysis of patterns of deliberate self harm in Bristol 1972–3 and 1995–6. Psychology 2000;30:1197–1203.Google ScholarPubMed
Hawton, K., Harriss, L., Hodder, K., Simkin, S., Gunnell, D.The influence of the economic and social environment on deliberate self-harm and suicide: an ecological and person-based study. Psychol Med 2001;31:827–836.CrossRefGoogle ScholarPubMed
Hawton, K., Zahl, D., Weatherall, R.Suicide following deliberate self-harm: long-term follow-up of patients who presented to a general hospital. Br J Psychiatry 2003;182:537–542.CrossRefGoogle ScholarPubMed
Hawton, K., Bergen, H., Casey, D.et al.Self-harm in England: a tale of three cities. Multicentre study of self-harm. Soc Psychiatry and Psychiatric Epidemiol 2007;42:513–521.CrossRefGoogle ScholarPubMed
Kessler, R.C., Ormel, J., Petukhova, M.et al.Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 2011;68:90–100.CrossRefGoogle ScholarPubMed
Madsen, T., Agerbo, E., Mortensen, P.B., Nordentoft, M.Predictors of psychiatric inpatient suicide: a national prospective register-based study. J Clin Psychiatry 2012;73:144–151.CrossRefGoogle ScholarPubMed
Mannuzza, S., Klein, R.G., Addalli, K.A.Young adult mental status of hyperactive boys and their brothers: a prospective follow-up study. J Am Acad Child Adolesc Psychiatry 1991;30:743–751.Google ScholarPubMed
Mannuzza, S., Klein, R.G., Bonagura, N., Malloy, P., Giampino, T.L., Addalli, K.A.Hyperactive boys almost grown up V. Replication of psychiatric status. Arch Gen Psychiatry 1991;48:77–83.CrossRefGoogle ScholarPubMed
Mannuzza, S., Klein, R.G., Bessler, A., Malloy, P., LaPadula, M.Adult psychiatric status of hyperactive boys grown up. Am J Psychiatry 1998;155:493–498.CrossRefGoogle ScholarPubMed
Miller, T.W., Nigg, J.T., Faraone, S.V.Axis I and II comorbidity in adults with ADHD. J Abnorm Psychol 2007;116:519–528.CrossRefGoogle ScholarPubMed
Perry, I.J., Corcoran, P., Fitzgerald, A.P., Keeley, H.S., Reulbach, U., Arensman, E.The incidence and repetition of hospital-treated deliberate self harm: findings from the world's first national registry. PLoS One 2012;7:e31663.CrossRefGoogle ScholarPubMed
Rasmussen, P., Gillberg, C.Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 2000;39:1424–1431.CrossRefGoogle ScholarPubMed
Satterfield, J.H., Schell, A.A prospective study of hyperactive boys with conduct problems and normal boys: adolescent and adult criminality. J Am Acad Child Adolesc Psychiatry 1997;36:1726–1735.CrossRefGoogle ScholarPubMed
Skegg, K.Self-harm. Lancet 2005;366:1471–1483.CrossRefGoogle ScholarPubMed
Sobanski, E.Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 2006;256:i26–i31.CrossRefGoogle Scholar
Swanson, J.M., Sergeant, J.A., Taylor, E., Sonuga-Barke, E.J., Jensen, P.S., Cantwell, D.P.Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet 1998;351:429–433.CrossRefGoogle ScholarPubMed
Weiss, G., Hechtman, L.Hyperactive Children Grown Up. New York: Guilford; 1986.Google Scholar
Wilens, T.E., Biederman, J., Faraone, S.V., Martelon, M., Westerberg, D., Spencer, T.J.Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD. J Clin Psychiatry 2009;70:1557–1562.CrossRefGoogle ScholarPubMed
William, J., Barbaresi, , Robert, C.et al.Katusic mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study. Pediatrics 2013;131:2012–2354.Google Scholar
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