2026 ECNP Congress

PS03-3159

Suicide risk and psychosocial profile in ADHD: a descriptive real-world study

Mauro Scala — G. Fanelli, L. Bassani, M. Lamberti, D. Arcangeli, I. de la Osa Subtil, R. Bortoletto, M. Garzitto, M. Colizzi · Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Madrid, Spain

2026 ECNP Congress

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition commonly diagnosed in childhood and persisting into adulthood. Symptom expression changes over time, with a decline in hyperactive–impulsive symptoms and persistence of inattentive features [1]. Meta-analytic evidence shows that patients with ADHD have higher rates of suicidal ideation (SI) and suicide attempts (SA) than the general population [2]. Increased suicidality is multifactorial, including impulsivity, emotional dysregulation, and psychiatric comorbidities [3].However, most evidence focuses on children or adults, with limited attention to the transition from adolescence to adulthood. This developmental phase is marked by increasing autonomy and changes in symptoms and psychosocial functioning, requiring tailored interventions [4].

Aims

To characterise suicidal risk and psychosocial adversity in adolescents with ADHD transitioning to adulthood in a tertiary clinical setting.

Methods

This retrospective real-world study included clinical data collected between 2013 and 2023 from patients with ADHD diagnosed through clinical history and a comprehensive psychodiagnostic evaluation according to Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria [5]. Suicidal risk was determined from clinical records based on documented SI, suicide plans, self-harm, and SA. Psychosocial adversities were systematically coded into predefined domains and summarised as the total number of adverse conditions. Data were analysed using descriptive statistics, with categorical variables expressed as frequencies and percentages, and continuous variables as mean (SD).

Results

In a clinical sample of adolescents with ADHD (N=267, mean age: 14.6 ± 2.02 years; inattentive [32.78%], hyperactive–impulsive [20.75%], combined presentation [46.06%]). Overall, 39.2 % of the sample had suicidal risk (19.4% low, 19.8% high), while 60.7% were classified as having no suicidal risk. Specifically, 35.6% had documented SI, 21.9% suicidal plans, 25.5% self-harm, and 15.8% at least one SA. Psychosocial adversity was highly prevalent, with over 95% of the sample having at least one adverse condition. The mean number of adverse conditions was 3.8 ± 1.98 (range: 0–8), with 3.7% reporting none, 43.7% having 1–3, 44.2% having 4–6, and 8.4% having ≥7. The most common frequent domains involved the family environment, including adverse caregiving or household conditions (58.6%), inadequate parental supervision or overprotection (57.2%), dysfunctional parent–child relationships (53.5%), impaired intra-familial communication (47.0%), and parental mental health problems (40.9%). Additional domains included interpersonal and traumatic experiences (44.7%), peer-related difficulties (27.9%), migration-related factors (20.9%), and institutional care or placement-related factors (24.2%).

Conclusions

In this tertiary-care sample, adolescents with ADHD showed frequent suicidal risk and co-occurring high psychosocial adversity, particularly within the family context. These descriptive findings suggest that suicide-risk assessment in ADHD should consider cumulative psychosocial adversity rather than focusing only on core ADHD symptoms. This pattern is consistent with models conceptualising suicidality as a partially distinct clinical dimension not fully explained by core disorder symptoms. As real-world descriptive data, these findings provide a basis for hypothesis generation and support context-sensitive psychosocial assessment during the transition to adulthood.

References

  1. Biederman, J., Faraone, S.V., 2005. Attention-deficit hyperactivity disorder. The Lancet 366(9481):237–248.
  2. Garas, P., Takacs, Z.K., Balázs, J.,2025. Longitudinal Suicide Risk in Children and Adolescents With Attention Deficit and Hyperactivity Disorder: A Systematic Review and Meta‐Analysis. Brain Behav 15(6):e70618.
  3. French, B., Nalbant, G., Wright, H., Sayal, K., Daley, D., Groom, M.J., et al. 2024. The impacts associated with having ADHD: an umbrella review. Front Psychiatry 15:1343314.
  4. Adrian, M., James, K.M., Gallop, R., Chu, P.V., Vander, Stoep, A., McCauley, E. 2025. Transitions in Suicide Risk from Early Adolescence to Early Adulthood. Arch Suicide Res 29(3):683–699.
  5. American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders, fifth ed. American Psychiatric Association Publishing, Washington.