ADHD, Depression and Suicide: What Parents Should Know

You're going to see it all over the news this week: New research suggests that children diagnosed with Attention Deficit/Hyperactivity Disorder face a much higher risk of depression and suicidal thoughts in adolescence. The results might allow the early identification of a high-risk group of kids.

In a study to be published in the October 2010 issue of Archives of General Psychiatry (a JAMA journal), Andrea Chronis-Tuscano and her colleagues followed children diagnosed with ADHD and a matched comparison group without the diagnosis. Their findings are bound to be shocking to parents of kids with the diagnosis: by age 14, 18.4% of children with ADHD and 5.7% of children in the comparison group had attempted suicide at least once! Ninety-six percent of kids with the diagnosis reported problems at home, with their friends, and at school. These are headline-making statistics, but a closer look is required to understand Chronis-Tuscano's findings.

Although the link between childhood ADHD diagnoses and later depression was a strong one (even after statistically controlling for other factors such as the mother's depression), kids who had ADHD but few other symptoms were actually at low risk. When emotional and behavioural problems were present in addition to distractibility, hyperactivity, and impulsivity, the risk increased dramatically. The authors concluded that there is a need to address not only the behavioural symptoms associated with ADHD, but the emotional reactions to these difficulties as well. These findings suggest that the medical approach to the disorder, which is aimed at hyperactive and inattentive symptoms, may not be sufficient to address the range of difficulties experienced by many adolescents with the diagnosis.

In a letter to Family Anatomy, Dr. Benjamin Lahey, one of the authors of the study, urged parents not to panic that their children with ADHD are likely to become depressed or attempt suicide. Instead, he hoped that parents "will conclude that ADHD in young children is not something to be ignored, but not a reason for alarm." He advised parents to seek help from a mental health professional who is trained in cognitive-behavioural therapy (CBT) with families, an approach that has been shown to be helpful for children with ADHD. Many self-help books detail some of the strategies that are used in CBT (see, for example, Taking Charge of ADHD by Dr. Russell Barkley), but Lahey noted that a professional could get to know the child and family well, and provide advice that would be tailored to the family's unique circumstances. Dr. Lahey's letter provides a simple breakdown of the implications of the study's findings:

The best thing a parent with a child with ADHD can do is seek qualified help.

You can find the latest issue of Archives of General Psychiatry here (Arch Gen Psychiatry. 2010;67[10]:1052-1059).

Note: Posts on Family Anatomy are for education only, and are not intended to replace professional or medical advice. If you need to talk to someone about family or mental health issues, you can get a referral from your family doctor.