Studies on attention-deficit hyperactivity disorder (ADHD) are scarce in adults with epilepsy. This study aimed to investigate the risk factors for ADHD and determine whether ADHD is directly associated with the risk of suicide in adults with epilepsy. ADHD was assessed using the Structured Clinical Interview for the 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 used. Suicide risk was defined as a MINI suicidality score of ≥ 1. Stepwise logistic regression and mediation analyses were conducted. Of the 157 adults with epilepsy, 19 (12.1 %) were diagnosed with ADHD, including inattentive (5.7 %), hyperactive (3.8 %), and combined (2.5 %) types. Thirty-two subjects (20.4 %) had a risk of suicide. ADHD was insignificantly associated with any epilepsy-related factors. The diagnosis of ADHD was not associated with suicide risk independent of NDDIE ≥ 14 and GAD-7 ≥ 7. Mediation effects of ADHD on suicidality using NDDIE ≥ 14 (odds ratio [OR] 2.850, 95 % confidence interval [CI] 1.398–5.811, p = 0.004) or GAD-7 ≥ 7 (OR 3.240, 95 % CI 1.537–6.828, p = 0.002) were statistically significant, with the proportion mediated being 84.5 % or 92.0 % of the total ADHD effect, respectively. These models were adjusted for age, sex, and composite epilepsy severity scores. ADHD was diagnosed in 12.1% of adults with epilepsy and was not associated with any epilepsy-related factors. ADHD was indirectly associated with the risk of suicide resulting from depression and anxiety in adults with epilepsy.

中文翻译：

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成人癫痫患者的注意力缺陷多动障碍：与自杀风险的间接关系

关于成人癫痫患者注意力缺陷多动障碍（ADHD）的研究很少。本研究旨在调查 ADHD 的危险因素，并确定 ADHD 是否与成人癫痫患者的自杀风险直接相关。 ADHD 使用 DSM-5 疾病临床版本的结构化临床访谈进行评估。还使用了迷你国际神经精神访谈 (MINI) Plus 5.0.0、癫痫神经疾病抑郁量表 (NDDIE) 和广泛性焦虑症 7 (GAD-7)。自杀风险定义为 MINI 自杀评分≥1。进行逐步逻辑回归和中介分析。在 157 名成人癫痫患者中，19 名（12.1%）被诊断患有 ADHD，包括注意力不集中（5.7%）、多动（3.8%）和混合型（2.5%）。三十二名受试者（20.4%）有自杀风险。 ADHD 与任何癫痫相关因素均无显着相关性。 ADHD 的诊断与独立于 NDDIE ≥ 14 和 GAD-7 ≥ 7 的自杀风险无关。使用 NDDIE ≥ 14 观察 ADHD 对自杀的中介效应（优势比 [OR] 2.850，95 % 置信区间 [CI] 1.398–5.811） , p = 0.004) 或 GAD-7 ≥ 7 (OR 3.240, 95 % CI 1.537–6.828, p = 0.002) 具有统计学意义，介导的比例分别占 ADHD 总效应的 84.5 % 或 92.0 %。这些模型根据年龄、性别和综合癫痫严重程度评分进行了调整。 12.1% 的成人癫痫患者被诊断为 ADHD，并且与任何癫痫相关因素无关。 ADHD 与成人癫痫患者因抑郁和焦虑而导致的自杀风险间接相关。