{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T19:23:54Z","timestamp":1769973834712,"version":"3.49.0"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The present study was designed to shed light on a topic rarely explored and to suggest possible ways to detect risk factors for the presence of suicidal ideation and behaviors in a sample of adult patients with Attention-Deficit Hyperactivity Disorder (ADHD). This study also explored the association between ADHD, affective temperaments, the presence of hypomania symptoms, and suicide risk. We hypothesized that (compared to healthy controls) (1) patients with adult ADHD would report more negative affective temperaments and more hypomania symptoms and (2) that they would have a higher suicide risk. The participants included 63 consecutive adult inpatients (18 women, 45 men) with ADHD and 69 healthy controls (42 women, 22 men). All participants were administered the Wender Utah Rating Scale (WURS), the Hypomania Check-List-32 (HCL-32), the Mood Disorder Questionnaire (MDQ), the Temperament Evaluation for Memphis, Pisa, Paris, and San Diego (TEMPS-A), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Forty-six percent of the ADHD patients had an Axis 1 comorbid disorder. ADHD patients (compared to controls) more often reported suicidal ideation (46.0% vs. 5.9%, one-way Fisher exact test p &lt; 0.001; phi = 0.46). ADHD patients and the controls also significantly differed in all the scales administered (with Cohen\u2019s d between 0.92\u20134.70), except for the TEMPS-A Hyperthymia scale. A regression model indicated that ADHD was independently associated with higher scores of a negative temperaments\/hypomania factor (Odd Ratio = 14.60) but not with suicidal ideation. A high incidence of suicidal ideation, comorbid psychiatric disorders, and negative affective temperaments was reported in adult ADHD patients, and clinicians should routinely assess risk factors for suicide among these patients.<\/jats:p>","DOI":"10.3390\/ijerph17082871","type":"journal-article","created":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T04:15:13Z","timestamp":1587528913000},"page":"2871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Characteristics of Mood Polarity, Temperament, and Suicide Risk in Adult ADHD"],"prefix":"10.3390","volume":"17","author":[{"given":"Giancarlo","family":"Giupponi","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Azienda Sanitaria dell\u2019Alto Adige, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1389-2290","authenticated-orcid":false,"given":"Marco","family":"Innamorati","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, Universit\u00e0 Europea di Roma, 00163 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2771-919X","authenticated-orcid":false,"given":"Elena","family":"Rogante","sequence":"additional","affiliation":[{"name":"Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8105-0370","authenticated-orcid":false,"given":"Salvatore","family":"Sarubbi","sequence":"additional","affiliation":[{"name":"Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Erbuto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignazio","family":"Maniscalco","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Azienda Sanitaria dell\u2019Alto Adige, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Sanna","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Azienda Sanitaria dell\u2019Alto Adige, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Conca","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Azienda Sanitaria dell\u2019Alto Adige, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1357-8672","authenticated-orcid":false,"given":"David","family":"Lester","sequence":"additional","affiliation":[{"name":"Department of Psychology, Stockton University, Galloway, NJ 08205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1886-4977","authenticated-orcid":false,"given":"Maurizio","family":"Pompili","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2217\/npy.14.16","article-title":"Attention-deficit\/hyperactivity disorder in adults: Update on clinical presentation and care","volume":"4","author":"Asherson","year":"2014","journal-title":"Neuropsychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/jclp.22317","article-title":"Emotional Dysregulation in Adults with Attention-Deficit\/Hyperactivity Disorder-Validity, Predictability, Severity, and Comorbidity","volume":"73","author":"Corbisiero","year":"2017","journal-title":"J. Clin. Psychol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1192\/bjp.bp.106.034389","article-title":"Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder","volume":"190","author":"Fayyad","year":"2007","journal-title":"Br. J. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s12402-016-0208-3","article-title":"The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys","volume":"9","author":"Fayyad","year":"2017","journal-title":"Atten. Defic. Hyperact. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s12402-012-0097-z","article-title":"Is emotional dysregulation part of the psychopathology of ADHD in adults?","volume":"5","author":"Corbisiero","year":"2013","journal-title":"Atten. Defic. Hyperact. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1192\/j.eurpsy.2019.11","article-title":"Toward operationalizing deficient emotional self-regulation in newly referred adults with ADHD: A receiver operator characteristic curve analysis","volume":"63","author":"Biederman","year":"2020","journal-title":"Eur. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1093\/alcalc\/agm069","article-title":"Nicotine and alcohol dependence in patients with comorbid attention-deficit\/hyperactivity disorder (ADHD)","volume":"42","author":"Ohlmeier","year":"2007","journal-title":"Alcohol Alcohol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.eurpsy.2018.11.001","article-title":"Updated European Consensus Statement on diagnosis and treatment of adult ADHD","volume":"56","author":"Kooij","year":"2019","journal-title":"Eur. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Kooij, S.J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugue, M., Carpentier, P.J., Edvinsson, D., Fayyad, J., Foeken, K., and Fitzgerald, M. (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry, 10.","DOI":"10.1186\/1471-244X-10-67"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Du Rietz, E., Jangmo, A., Kuja-Halkola, R., Chang, Z., D\u2019Onofrio, B.M., Ahnemark, E., Werner-Kiechle, T., and Larsson, H. (2020). Trajectories of healthcare utilization and costs of psychiatric and somatic multimorbidity in adults with childhood ADHD: A prospective register-based study. J. Child Psychol. Psychiatry.","DOI":"10.1111\/jcpp.13206"},{"key":"ref_12","first-page":"11","article-title":"Psychiatric Comorbidities in Adult Attention-deficit\/Hyperactivity Disorder: Prevalence and Patterns in the Routine Clinical Setting","volume":"16","author":"Ohnishi","year":"2019","journal-title":"Innov. Clin. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1176\/ajp.2006.163.4.716","article-title":"The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication","volume":"163","author":"Kessler","year":"2006","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/070674370905401004","article-title":"Comorbidity in adults with attention-deficit hyperactivity disorder","volume":"54","author":"Cumyn","year":"2009","journal-title":"Can. J. Psychiatry"},{"key":"ref_15","first-page":"1010","article-title":"Adult attention-deficit hyperactivity disorder: A database analysis of South African private health insurance","volume":"23","author":"Schoeman","year":"2017","journal-title":"S. Afr. J. Psychiatr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Valsecchi, P., Nibbio, G., Rosa, J., Tamussi, E., Turrina, C., Sacchetti, E., and Vita, A. (2018). Adult ADHD: Prevalence and Clinical Correlates in a Sample of Italian Psychiatric Outpatients. J. Atten. Disord.","DOI":"10.1177\/1087054718819824"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1542\/peds.2008-3347","article-title":"Do stimulants protect against psychiatric disorders in youth with ADHD? A 10-year follow-up study","volume":"124","author":"Biederman","year":"2009","journal-title":"Pediatrics"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Katzman, M.A., Bilkey, T.S., Chokka, P.R., Fallu, A., and Klassen, L.J. (2017). Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry, 17.","DOI":"10.1186\/s12888-017-1463-3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.4088\/JCP.v68n1118","article-title":"A systematic review of rates and diagnostic validity of comorbid adult attention-deficit\/hyperactivity disorder and bipolar disorder","volume":"68","author":"Wingo","year":"2007","journal-title":"J. Clin. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2009.06.036","article-title":"Adult ADHD and its comorbidities, with a focus on bipolar disorder","volume":"124","author":"Klassen","year":"2010","journal-title":"J. Affect. Disord."},{"key":"ref_21","first-page":"23","article-title":"The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention-deficit\/hyperactivity disorder","volume":"24","author":"Bond","year":"2012","journal-title":"Ann. Clin. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Olsen, J.L., Reimherr, F.W., Marchant, B.K., Wender, P.H., and Robison, R.J. (2012). The effect of personality disorder symptoms on response to treatment with methylphenidate transdermal system in adults with attention-deficit\/hyperactivity disorder. Prim. Care Companion CNS Disord., 14.","DOI":"10.4088\/PCC.12m01344"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/NMD.0000000000000470","article-title":"Personality Disorder in Adult Attention-Deficit\/Hyperactivity Disorder: Attrition and Change During Long-term Treatment","volume":"204","author":"Gift","year":"2016","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1600-0447.2011.01798.x","article-title":"Completed suicide, ideation and attempt in attention deficit hyperactivity disorder","volume":"125","author":"Impey","year":"2012","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.cpr.2012.11.005","article-title":"Attention-deficit\/hyperactivity disorder and adverse health outcomes","volume":"33","author":"Nigg","year":"2013","journal-title":"Clin. Psychol. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1542\/peds.2012-2354","article-title":"Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: A prospective study","volume":"131","author":"Barbaresi","year":"2013","journal-title":"Pediatrics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1001\/jamapsychiatry.2019.1944","article-title":"Association of Psychiatric Comorbidity With the Risk of Premature Death Among Children and Adults With Attention-Deficit\/Hyperactivity Disorder","volume":"76","author":"Sun","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s12402-014-0150-1","article-title":"Adult ADHD and suicide","volume":"6","author":"Furczyk","year":"2014","journal-title":"Atten. Defic. Hyperact. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.comppsych.2018.06.003","article-title":"Suicidal ideation in adult ADHD: Gender difference with a specific psychopathological profile","volume":"85","author":"Kakuszi","year":"2018","journal-title":"Compr. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1001\/jamapsychiatry.2014.363","article-title":"Common etiological factors of attention-deficit\/hyperactivity disorder and suicidal behavior: A population-based study in Sweden","volume":"71","author":"Ljung","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"ref_31","first-page":"885","article-title":"The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder","volume":"150","author":"Ward","year":"1993","journal-title":"Am. J. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1176\/jnp.12.2.240","article-title":"Discriminant validity of the Wender Utah Rating Scale for attention-deficit\/hyperactivity disorder in adults","volume":"12","author":"McCann","year":"2000","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jad.2005.05.011","article-title":"The HCL-32: Towards a self-assessment tool for hypomanic symptoms in outpatients","volume":"88","author":"Angst","year":"2005","journal-title":"J. Affect. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1176\/appi.ajp.157.11.1873","article-title":"Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire","volume":"157","author":"Hirschfeld","year":"2000","journal-title":"Am. J. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2004.12.003","article-title":"TEMPS: Temperament Evaluation of Memphis, Pisa, Paris and San Diego","volume":"85","author":"Akiskal","year":"2005","journal-title":"J. Affect. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jad.2007.07.031","article-title":"TEMPS-A (Rome): Psychometric validation of affective temperaments in clinically well subjects in mid- and south Italy","volume":"107","author":"Pompili","year":"2007","journal-title":"J. Affect. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1176\/appi.ajp.2011.10111704","article-title":"The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults","volume":"168","author":"Posner","year":"2011","journal-title":"Am. J. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/1087054708314621","article-title":"Untreated ADHD in adults: Are there sex differences in symptoms, comorbidity, and impairment?","volume":"12","author":"Rasmussen","year":"2009","journal-title":"J. Atten. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.psychres.2010.07.047","article-title":"Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study","volume":"186","author":"Park","year":"2011","journal-title":"Psychiatry Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1177\/1087054713517544","article-title":"Associations of Age, Gender, and Subtypes With ADHD Symptoms and Related Comorbidity in a Danish Sample of Clinically Referred Adults","volume":"20","author":"Soendergaard","year":"2016","journal-title":"J. Atten. Disord."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Breda, V., Rohde, L.A., Menezes, A.M.B., Anselmi, L., Caye, A., Rovaris, D.L., Vitola, E.S., Bau, C.H.D., and Grevet, E.H. (2019). Revisiting ADHD age-of-onset in adults: To what extent should we rely on the recall of childhood symptoms?. Psychol. Med., 1\u201310.","DOI":"10.1017\/S003329171900076X"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/1087054715573992","article-title":"Prevalence and Correlates of Self-Reported ADD\/ADHD in a Large National Sample of Canadian Adults","volume":"22","author":"Hesson","year":"2018","journal-title":"J. Atten. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1177\/1087054713518238","article-title":"ADHD and Suicidal Ideation: The Roles of Emotion Regulation and Depressive Symptoms Among College Students","volume":"19","author":"Ballard","year":"2015","journal-title":"J. Atten. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jad.2011.05.008","article-title":"Does Attention Deficit Hyperactivity Disorder increase the risk of suicide attempts?","volume":"133","author":"Agosti","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.jad.2017.06.040","article-title":"Depressive symptoms and the role of affective temperament in adults with attention-deficit\/hyperactivity disorder (ADHD): A comparison with bipolar disorder","volume":"221","author":"Torrente","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jad.2012.10.011","article-title":"Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder","volume":"147","author":"Skirrow","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4306\/pi.2013.10.2.137","article-title":"Temperamental characteristics in adults with attention-deficit hyperactivity disorder: A comparison with bipolar disorder and healthy control groups","volume":"10","author":"Ekinci","year":"2013","journal-title":"Psychiatry Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jad.2012.04.034","article-title":"The impact of cyclothymic temperament in adult ADHD","volume":"142","author":"Landaas","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/YCO.0b013e32833299d4","article-title":"Current research on affective temperaments","volume":"23","author":"Rihmer","year":"2010","journal-title":"Curr. Opin. Psychiatry"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:09:12Z","timestamp":1760364552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,21]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["ijerph17082871"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17082871","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,21]]}}}