Evaluation of the relationship between attention deficit and hyperactivity disorder (ADHD) symptoms and aggression, self-harm and suicidal behaviors in drug users

Aim: The aim of our study was to examine the relationship between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and non-suicidal self-injury, suicidal and aggressive behaviors in drug users according to the type of substance used. We aimed to review the complex relationship between the different comorbid conditions identified in this study. Materials and Methods: In our study, the cases who were processed by the judicial authorities to our Düzce University Faculty of Medicine, Department of Forensic Medicine between 01.05.2023 and 31.12.2023 due to suspicion of drug use and who were already examined and sampled in accordance with the request of the judicial authorities and studied in the pharmacology laboratory of our University and for whom a report was issued to the judicial authorities were studied. Sociodemographic information obtained from the subjects who voluntarily wanted to participate in the study and the adult attention deficit and hyperactivity disorder screening scale (ASRS), Inventory of Statements about Self Injury (ISAS), suicidal behavior scale and Buss-Perry Aggression Scale and pharmacology laboratory results were included. Results: A total of 185 subjects were reached in our study, but 25 subjects were excluded from the study due to negative drug tests and incomplete questionnaires. 160 cases who were found to be drug positive in the urine samples analyzed by LC/MS method by the pharmacology laboratory were included in our study. The cases were divided into groups according to the questionnaires and the results of the urine sample. Of the 160 cases, 63 (39%) showed a high risk of ADHD according to the ASRS scale, 33 (20%) tested positive for more than one drug, 77 (48%) engaged in self-destructive behavior, 100 (62%) stated that they had thought of killing themselves at least once before, and 36 (22%) were at high risk of aggression. Conclusion: In our study, we discussed the factors affecting ADHD and dangerous behavioral patterns of self-harm, suicide and aggression in drug users. In our study, we found a higher risk of ADHD in drug users compared to the population risk average. In our study, there was no statistically significant relationship between the presence of ADHD symptoms and a higher risk of self-harm, suicide or aggression. However, the fact that higher suicidal behavior scores and total and subscale scores of the aggression scale were found in the high-risk group in terms of ADHD, although not at a statistically significant level, is important in terms of predicting that individuals with ADHD may attempt more suicide and increased risk of aggression in different subtypes (verbal aggression, physical aggression, etc.). Therefore, it is thought that it will be important to provide preventive health services to individuals with ADHD regarding self-harmful and environmentally damaging behaviors.