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Home » Self-Harm in Adolescents With ADHD

Self-Harm in Adolescents With ADHD

October 18, 2021
Pavan Madan, MD.
From The Carlat Child Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Pavan Madan, MD. Dr. Madan has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
REVIEW OF: Balázs J et al, BMC Psychiatry 2018;18(1):34

What is the relationship between ADHD and self-harm and what can we do about it? ADHD is quite common, affecting 4%–6% of children and adolescents, and non-suicidal self-injury (NSSI) is also common, affecting about 5% of all people in the community and up to 80% of people with psychiatric diagnoses. Furthermore, about two-thirds of patients with ADHD have comorbid psychiatric disorders, often mood and anxiety disorders. This study explores factors that might mediate the association between ADHD and NSSI.

Researchers interviewed 202 psychiatric inpatient adolescents (99 boys and 103 girls) ages 13–18 at a facility in Hungary. To assess for DSM-IV psychiatric conditions, they used a structured diagnostic interview via the modified Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid). For NSSI, researchers used the 17-item Deliberate Self-Harm Inventory (DSHI), which contains questions related to the frequency, severity, and duration of self-harm.

The authors found that 25% of adolescents had ADHD (n = 52; 23% of boys and 28% of girls) and another 38% scored at subthreshold level for ADHD symptoms (n = 77; 40% of boys and 36% of girls). An astounding 86% of girls (n = 25) and 43% of boys (n = 10) with ADHD had NSSI. Statistical analysis showed that ADHD and NSSI were not directly related. Instead, the likelihood of having both ADHD and NSSI could be explained by comorbidities. The most significant of these comorbidities included affective disorders, psychotic disorders, an independent state of suicidality, and (for girls) alcohol abuse or dependence.

CCPR’s Take:
Since inpatient treatment is generally reserved for adolescents who have suicidal ideation or NSSI, it is no surprise that ADHD and NSSI track together in these patients. However, the gem in this study is that it points us toward prioritizing treatment of comorbid conditions to reduce NSSI rather than being too distracted [sic] by the ADHD.
Child Psychiatry
KEYWORDS adhd affective-disorders co-morbidities non-suicidal-self-injury psychotic-disorders suicidality
Pavan Madan, MD.

The Evidence Base for Polypharmacy in ADHD

More from this author
www.thecarlatreport.com
Issue Date: October 18, 2021
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Table Of Contents
CME Post-Test - Overarousal in Children and Adolescents, CCPR, October/November/December 2021
Assessing Bipolar Disorder in Children and Adolescents
Unpacking Aggression Associated with ADHD
Tools to Help Kids and Teens to Sleep Better
Using Equine-Assisted Psychotherapy
Dash Diet for Childhood ADHD
Quetiapine vs First-Generation Antipsychotics for Aggression
Self-Harm in Adolescents With ADHD
A Novel Treatment for Dramatic-Onset Autoimmune OCD or Severe Food ­Restriction?
Note From the Editor-in-Chief
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