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.