Suicidal behaviors and attention deficit hyperactivity disorder (ADHD): a cross-sectional study among Chinese medical college students.

BACKGROUNDS: Associations between attention deficit hyperactivity disorder (ADHD) subtypes and suicidal behaviors remains unclear. The current study explored the prevalence of suicidal behaviors, and its association with ADHD among Chinese medical students. METHODS: Five thousand six hundred ninety-three medical college students participated. Symptoms of suicidal behaviors, ADHD, anxiety, depression, tobacco and alcohol use were assessed using online questionnaires. RESULTS: The prevalence of lifetime suicidal ideation, suicide plans, and suicide attempts among medical college students were 27.5, 7.9 and 14.8% respectively. Participants with ADHD predominantly inattentive type (ADHD-I) had more than fivefold increased odds of suicidal behaviors, the adjusted odds ratios (ORs) of ADHD-I and ADHD combined type (ADHD-C) remained significant after controlling for confounding factors. CONCLUSIONS: ADHD is associated with high risk of suicidal behaviors. ADHD-I and ADHD-C were strongly associated with suicidal behaviors independent of comorbidities. The finding suggests the importance of addressing ADHD symptoms in suicide prevention.

Detecting risk of suicide attempts among Chinese medical college students using a machine learning algorithm.

BACKGROUND: Suicide has become one of the most prominent concerns for public health and wellness; however, detecting suicide risk factors among individuals remains a big challenge. The aim of this study was to develop a machine learning algorithm that could effectively and accurately identify the probability of suicide attempts in medical college students. METHODS: A total of 4,882 medical students were enrolled in this cross-sectional study. Self-report data on socio-demographic and clinical characteristics were collected online via website or through the widely used social media app, WeChat. 5-fold cross validation was used to build a random forest model with 37 suicide attempt predictors. Model performance was measured for sensitivity, specificity, area under the curve (AUC), and accuracy. All analyses were conducted in MATLAB. RESULTS: The random forest model achieved good performance [area under the curve (AUC) = 0.9255] in predicting suicide attempts with an accuracy of 90.1% (SD = 0.67%), sensitivity of 73.51% (SD = 2.33%) and specificity of 91.68% (SD = 0.82%). LIMITATION: The participants are primarily females and medical students. CONCLUSIONS: This study demonstrates that the random forest model has the potential to predict suicide attempts among medical college students with high accuracy. Our findings suggest that application of the machine learning model may assist in improving the efficiency of suicide prevention.

Association of ADHD symptoms, depression and suicidal behaviors with anxiety in Chinese medical college students.

BACKGROUND: Anxiety is one of the most common psychiatric disorder and imposes a great burden on both the individual and the society. Previous studies indicate a high comorbidity of anxiety disorders and Attention Deficit Hyperactivity Disorder (ADHD). However, few studies have examined the comorbidity of anxiety and ADHD among medical college students in mainland China. This study aimed to examine the prevalence of anxiety and the associated risk factor of anxiety disorder as well as to explore the association between ADHD symptoms, depression, suicidal behaviors and anxiety. METHODS: A cross-sectional design was employed among 4882 medical college students who were recruited and enrolled with convenience sampling. Self-reported demographic information and clinical characteristics were collected online on a computer or through a social media app named Wechat. RESULTS: The prevalence of anxiety in this study was 19.9%. Students with anxiety were more likely to have a poor relationship with parents, be of Han nationality, have smoking or drinking habits, have an extensive physical disorder history and have engaged in suicidal behaviors. The independent risk factors for anxiety were: smoking, physical disorder history, suicidal ideations, suicide attempts, inattention and hyperactivity. Significant associations were observed between anxiety and depression, inattention, hyperactivity, suicide plans and suicide attempts. CONCLUSIONS: Nearly one in five medical students suffered from anxiety. The findings of this study indicate the importance of addressing both anxiety and ADHD symptoms in order to better promote mental health and the well-being of medical students as well as reduce suicidal behaviors.

Estimated prevalence and associated risk factors of attention deficit hyperactivity disorder (ADHD) among medical college students in a Chinese population.

BACKGROUND: To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) among medical college students in a Chinese population. METHODS: A cross-sectional design was used to collect demographic data on participants and their symptoms of ADHD, anxiety, and depression. Data were collected through questionnaires filled out on a computer or through WeChat, a widely used social media app. RESULTS: The prevalence of ADHD among 5693 college students was 3.5% (3.02∼3.98%). Individuals with ADHD showed higher scores on scales of anxiety and depression symptoms (both p < 0.05) than the general population. There was a significant difference in the prevalence of ADHD grouped by smoking, drinking, suicidal ideation, suicidal plans, suicidal attempt, anxiety and depression (p < 0.05). The odds ratio (OR) of ADHD was high for suicidal ideation, suicide plans, suicide attempts, anxiety and depression, with ORs of 5.901, 5.46, 6.011, 8.037 and 7.88, respectively. The ORs of suicidal behaviors for ADHD were decreased after adjusting for covariates such as drinking, smoking and depression. LIMITATIONS: The sample was exclusively selected from three medical-related colleges, which might not be best representation of college students in China. Furthermore, majority of the participants were females. CONCLUSIONS: ADHD remains a common disorder among Chinese medical college students and is significantly associated with suicidal behaviors, anxiety and depression. It is important to increase awareness and promote effective interventions to this particular population.

The prevalence of psychiatric disorders among students aged 6~ 16 years old in central Hunan, China.

BACKGROUND: Though several epidemiological surveys of psychiatric disorders have been carried out in China, only a few of them are concerned about the prevalence of psychiatric disorders in central Hunan and reveal the distribution of common psychiatric disorders and their comorbidities. METHODS: Achenbach's Child Behavior Checklist (CBCL), the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) were administered to a stratified sample of 17,071 participants aged 6 to 16 years old from two cities in the central part of Hunan province. Twelve-month prevalence rates were calculated. RESULTS: Twelve-month prevalence of the population was 9.74%. The most common psychiatric disorders were attention deficit hyperactivity disorder (ADHD) (4.96%), oppositional defiant disorder (ODD) (2.98%) and generalized anxiety disorder (GAD) (1.77%). Of those with a 12-month prevalence diagnosis, 34.6% had one or more comorbid psychiatric disorders. Most notably, ADHD had comorbidity rates of 25.15% with ODD, 18.18% with CD, 6.38% with GAD, and 3.66% with MDD. CONCLUSIONS: Psychiatric disorders are common in Chinese children and adolescents. Being the most prevalent mental disorder, ADHD requires continued focus and support in awareness and education.