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Association of hyperactivity-impulsivity and inattention symptoms profiles with suicide attempt: a 18-year population-based cohort study

Association of hyperactivity-impulsivity and inattention symptoms profiles with suicide attempt: a 18-year population-based cohort study
Association of hyperactivity-impulsivity and inattention symptoms profiles with suicide attempt: a 18-year population-based cohort study
Aims: attention-deficit/hyperactivity disorder (ADHD) symptomatology in childhood is associated with a high risk of suicide attempt later in life. However, symptoms presentation in ADHD is heterogeneous, and little is known about how suicide risk varies according to different profiles of ADHD symptoms and sex. The aim was to investigate the longitudinal associations between childhood profiles of ADHD symptoms (i.e., hyperactivity-impulsivity and inattention) and youth suicide attempt in males and females, separately.

Methods: this population-based cohort study used data from three longitudinal cohorts: the Quebec Longitudinal Study of Child Development the Quebec Longitudinal Study of Kindergarten Children, and the Quebec Newborn Twin Study for a total of 4,399 participants (1490 from the QLSCD, 2134 from the QLSKC, and 775 from the QNTS; 50% females) followed up from age 6 to age 23 years. Symptoms of hyperactivity-impulsivity and inattention were assessed by teachers 5 times from ages 6 to 12 years. Suicide attempt in adolescence and young adulthood (by age 23) was self-reported. Multi-trajectory modelig was used to identify profiles of ADHD symptoms, and regression analysis was used to test their association with suicide attempt, adjusting for childhood socioeconomic and clinical characteristics.

Results: we identified four ADHD symptoms profiles with distinct associations with suicide attempt for males and females. Compared with those with persistently low symptoms, females with persistently high inattention and hyperactivity-impulsivity (OR: 2.54, CI 1.39-4.63) or high inattention and low hyperactivity-impulsivity (OR: 1.81, CI 1.21-2.70) were at higher risk of suicide attempt, while, among males, only those with decreasing hyperactivity-impulsivity and inattention over time (OR: 2.23, CI 1.20-4.13) were at higher risk of suicide attempt.

Conclusions: suicide risk in children with ADHD symptoms varies according to both symptoms profile and sex, the highest risk being for females with high inattention symptoms (with or without hyperactivity), and males with decreasing symptoms. Accounting for these differences may be relevant to more accurately identify and manage suicide risk in individuals with ADHD.
Child & adolescent psychiatry, Suicide & self-harm
2755-9734
Spodenkiewicz, Michel
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Inja, Ayla
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Cortese, Samuele
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Galera, Cédric
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Ouellet-Morin, Isabelle
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Côté, Sylvana M.
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Boivin, Michel
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Vitaro, Frank
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Brengden, Mara
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Dionne, Ginette
ff85c0cb-4b48-4b7c-9369-00b28d3f91d9
Renaud, Johanne
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Tremblay, Richard E.
e3b19abe-76ea-4b92-96fe-9550853c8304
Turecki, Gustavo
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Geoffroy, Marie-Claude
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Orri, Massimiliano
c8771cc4-a2fe-4022-8bac-7e0d3292d1db
Spodenkiewicz, Michel
5f11921a-b332-4059-a5a9-28f56caf5507
Inja, Ayla
cb0a6424-494d-405a-a13c-a479b7e31cab
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Galera, Cédric
af967cde-ac35-4a57-a361-255070386576
Ouellet-Morin, Isabelle
45922b83-a448-4510-86b8-44ed764ee6bd
Côté, Sylvana M.
5d469462-c6e6-406b-b006-f767a4e00d59
Boivin, Michel
06aec491-277e-406f-8ab0-f144176334eb
Vitaro, Frank
90ce08b0-77ef-4b56-827f-e5d70e75338d
Brengden, Mara
db6e6503-eef1-47a3-9783-2cce539ce9de
Dionne, Ginette
ff85c0cb-4b48-4b7c-9369-00b28d3f91d9
Renaud, Johanne
64680c24-4faf-41bf-9876-88245665222b
Tremblay, Richard E.
e3b19abe-76ea-4b92-96fe-9550853c8304
Turecki, Gustavo
bcca472e-a9fa-4559-a652-ef39db8fb8fc
Geoffroy, Marie-Claude
72efc491-dfda-4f52-87a6-9106f00f3cc7
Orri, Massimiliano
c8771cc4-a2fe-4022-8bac-7e0d3292d1db

Spodenkiewicz, Michel, Inja, Ayla, Cortese, Samuele, Galera, Cédric, Ouellet-Morin, Isabelle, Côté, Sylvana M., Boivin, Michel, Vitaro, Frank, Brengden, Mara, Dionne, Ginette, Renaud, Johanne, Tremblay, Richard E., Turecki, Gustavo, Geoffroy, Marie-Claude and Orri, Massimiliano (2025) Association of hyperactivity-impulsivity and inattention symptoms profiles with suicide attempt: a 18-year population-based cohort study. BMJ Mental Health, 28 (1), [e301725]. (doi:10.1136/bmjment-2025-301725).

Record type: Article

Abstract

Aims: attention-deficit/hyperactivity disorder (ADHD) symptomatology in childhood is associated with a high risk of suicide attempt later in life. However, symptoms presentation in ADHD is heterogeneous, and little is known about how suicide risk varies according to different profiles of ADHD symptoms and sex. The aim was to investigate the longitudinal associations between childhood profiles of ADHD symptoms (i.e., hyperactivity-impulsivity and inattention) and youth suicide attempt in males and females, separately.

Methods: this population-based cohort study used data from three longitudinal cohorts: the Quebec Longitudinal Study of Child Development the Quebec Longitudinal Study of Kindergarten Children, and the Quebec Newborn Twin Study for a total of 4,399 participants (1490 from the QLSCD, 2134 from the QLSKC, and 775 from the QNTS; 50% females) followed up from age 6 to age 23 years. Symptoms of hyperactivity-impulsivity and inattention were assessed by teachers 5 times from ages 6 to 12 years. Suicide attempt in adolescence and young adulthood (by age 23) was self-reported. Multi-trajectory modelig was used to identify profiles of ADHD symptoms, and regression analysis was used to test their association with suicide attempt, adjusting for childhood socioeconomic and clinical characteristics.

Results: we identified four ADHD symptoms profiles with distinct associations with suicide attempt for males and females. Compared with those with persistently low symptoms, females with persistently high inattention and hyperactivity-impulsivity (OR: 2.54, CI 1.39-4.63) or high inattention and low hyperactivity-impulsivity (OR: 1.81, CI 1.21-2.70) were at higher risk of suicide attempt, while, among males, only those with decreasing hyperactivity-impulsivity and inattention over time (OR: 2.23, CI 1.20-4.13) were at higher risk of suicide attempt.

Conclusions: suicide risk in children with ADHD symptoms varies according to both symptoms profile and sex, the highest risk being for females with high inattention symptoms (with or without hyperactivity), and males with decreasing symptoms. Accounting for these differences may be relevant to more accurately identify and manage suicide risk in individuals with ADHD.

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Accepted/In Press date: 3 June 2025
e-pub ahead of print date: 11 July 2025
Published date: 11 July 2025
Keywords: Child & adolescent psychiatry, Suicide & self-harm

Identifiers

Local EPrints ID: 503218
URI: http://eprints.soton.ac.uk/id/eprint/503218
ISSN: 2755-9734
PURE UUID: 99c09c16-ab1d-427b-8ba0-92d9b7c86cbb
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

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Date deposited: 24 Jul 2025 16:38
Last modified: 16 Sep 2025 02:01

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Contributors

Author: Michel Spodenkiewicz
Author: Ayla Inja
Author: Samuele Cortese ORCID iD
Author: Cédric Galera
Author: Isabelle Ouellet-Morin
Author: Sylvana M. Côté
Author: Michel Boivin
Author: Frank Vitaro
Author: Mara Brengden
Author: Ginette Dionne
Author: Johanne Renaud
Author: Richard E. Tremblay
Author: Gustavo Turecki
Author: Marie-Claude Geoffroy
Author: Massimiliano Orri

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