German researchers have found new evidence that attention-deficit hyperactivity disorder (ADHD) increases the risk of suicide attempts, eating disorders and post-traumatic stress disorder (PTSD).
The new study published in the journal BMJ Mental Health has found that ADHD is an independent risk factor for several common and serious mental health issues.
Researchers also found evidence that clinical depression can cause, and be caused by, ADHD, and recommended that healthcare professionals closely monitor people with ADHD to help prevent these disorders.
ADHD is a neurodevelopmental condition in children and teens that extends into adulthood in up to around two-thirds of cases.
Worldwide, its prevalence is estimated to be around 5% in children and teens and 2.5% in adults.
ADHD has previously been linked to mood and anxiety disorders in observational studies, but it’s not known if it’s causally associated with other mental health issues.
To try and find out, the researchers used ‘Mendelian randomisation’, which uses genetics to allow scientists to determine whether one thing causes another, rather than them just being linked.
In this case, it was ADHD’s link to seven common mental health issues namely major clinical depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD, anorexia nervosa and at least one suicide attempt.
The researchers initially used the technique to establish potential links between ADHD and the seven disorders. They then used it to see if disorders associated with ADHD could potentially be responsible for the effects detected in the first analysis. Finally, they pooled the data from both analyses to calculate the direct and indirect effects of ADHD.
The results showed no evidence of a causal link between ADHD and bipolar disorder, anxiety, or schizophrenia.
However, there was evidence for a causal link between a heightened risk of anorexia nervosa (28%) and proof that ADHD both caused (9% heightened risk) and was caused by (76% heightened risk) major clinical depression.
After adjusting for major depressive disorder, ADHD was still associated with an increased risk of suicide attempts (30%) and PTSD (18%).
The researchers caution that the study’s limitations make pinpointing the relevant causal effect difficult. Additionally, only people of European ancestry were included, so the findings might not apply to other ethnicities.
Nevertheless, the researchers conclude that their findings should encourage clinicians to be more proactive when treating people with ADHD.
‘This study opens new insights into the paths between psychiatric disorders,’ wrote the researchers. ‘Thus, in clinical practice, patients with ADHD should be monitored for the psychiatric disorders included in this study and preventive measures should be initiated if necessary.’
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