Attention-deficit Hyperactivity Disorder in Adults with Epilepsy: Associated Factors and a Relationship with a Suicide Risk
Abstract number :
1.349
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2023
Submission ID :
278
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Eunju Choi, PhD – Asan Medical Center
Kayeong Im, MD – Asan Medical Center; Mina Jung, MD – Asan Medical Center; Jin Young Seo, MD – Asan Medical Center; Sang-Ahm Lee, MD, PhD – Asan Medical Center
Rationale: Studies on attention-deficit hyperactivity disorder (ADHD) in adults with epilepsy are scares. Literature shows an association between ADHD and suicidal behavior. It remains controversial whether there is a direct relationship. We aimed (1) to investigate the prevalence of ADHD in adults with epilepsy and (2) to determine whether ADHD is directly associated with suicidality in adults with epilepsy.
Methods: Adults with epilepsy who had no difficulties in verbal or written communication were included in the cross-sectional study. ADHD was assessed using the Structured Clinical Interview for DSM-5@ Disorders Clinical Version. The Mini International Neuropsychiatric Interview (MINI) Plus 5.0.0, Neurological Disorders Depression Inventory for Epilepsy (NDDIE), and Generalized Anxiety Disorder-7 (GAD-7) were also use. The presence of suicide risk was defined as a MINI suicidality score ≥ 1. Stepwise logistic regression and mediation analyses using a two-stage regression method were performed.
Results: : Of the 157 subjects included (men 54.1%; mean age 37.7±10.5 years), 19 (12.1%) had screened positive for ADHD including inattentive (n=9; 5.7%), hyperactive (n=6; 3.8%), and combined (n=4; 2.5%) types. The suicide risk was identified in 32 (20.4%) subjects with 13 (8.3%) having the moderate level of suicide risk. The presence of ADHD was not directly associated with the suicide risk independent of NDDIE ≥14 and GAD-7 ≥7. In a separate adjusted model, mediation effects of ADHD on suicidality via NDDIE ≥14 (natural indirect effect: OR 2.850, 95% CI 1.398-5.811, p=0.004) or GAD-7 ≥7 (natural indirect effect: OR 3.240, 95% CI 1.537-6.828, p=0.002) were statistically significant, with the proportion mediated 84.5% or 92.0% of the total effect for ADHD, respectively. These models were adjusted for age, sex, and composite epilepsy severity scores.
Conclusions: The prevalence rate of ADHD was 12.1% in adults with epilepsy. ADHD was indirectly associated with a suicide risk via depression and anxiety in adults with epilepsy.
Funding: None
Behavior