Completed suicide, ideation and attempt in attention deficit hyperactivity disorder.

Objective:   Attention deficit hyperactivity disorder (ADHD) and suicidal behaviour are common conditions with significant social and emotional morbidity. Although completed suicide in ADHD has been assessed in a previous meta-analysis, other domains of suicidal behaviour such as attempts and ideation have been documented only in individual studies. This review provides a comprehensive summary of the relationship between attention-deficit and suicidality. Method:   Electronic and manual literature search of MEDLINE, EMBASE and PSYCHINFO, using a range of search terms around suicidality, attention-deficit and hyperactivity. Results:   Twenty five papers were identified describing a relationship between ADHD and suicide. ADHD occurred more frequently in suicidal groups than controls, with most differences being statistically significant. The direction of results was consistent, with only one sample showing equivocal findings and one showing a reverse pattern. Attempts and ideation were more common in prediagnosed ADHD samples than controls. Three studies showed significant results only for men. Comorbidity had a large influence including delinquency and substance misuse. Conclusion:   There is a positive relationship between ADHD and risk to self. More focussed research needs to take place on younger populations and those without comorbidity. This review highlights the importance of thorough risk assessment in the attention-deficit population.