Objective: To estimate the association between ADHD symptoms and suicidal ideation in college students, and to test mediation by depressive symptoms or self-esteem. Method: Based on the i-Share cohort (prospective cohort of 2,331 college students in France). Self-reported measures included ADHD symptoms at baseline, self-esteem and depressive symptoms at 3 months, and suicidal ideation at 1-year follow-up. We conducted path analysis to estimate total, direct, and indirect effect. Results: Participants with high ADHD symptoms were more likely to report suicidal ideation 1 year later (p < .0001). Indirect effects through depressive symptoms (p < .0001) and self-esteem (p < .0001) explained 44% and 25% of this association, respectively. An indirect pathway via a combination of self-esteem, then depressive symptoms, was also identified (p < .0001), explaining 19% of the total effect. The direct effect was not significant (p = .524). Conclusion: ADHD symptoms seem to have no direct but indirect effect through both self-esteem and depressive symptoms on suicidal ideation.

中文翻译：

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大学期间从 ADHD 症状到自杀意念的途径：对 i-Share 队列的纵向研究。

目的：评估大学生多动症症状与自杀意念之间的关联，并检验抑郁症状或自尊的中介作用。方法：基于 i-Share 队列（法国 2,331 名大学生的预期队列）。自我报告的测量包括基线时的 ADHD 症状、3 个月时的自尊和抑郁症状以及 1 年随访时的自杀意念。我们进行了路径分析来估计总的、直接的和间接的影响。结果：具有高度 ADHD 症状的参与者更有可能在 1 年后报告自杀意念（p < .0001）。通过抑郁症状 (p < .0001) 和自尊 (p < .0001) 产生的间接影响分别解释了这种关联的 44% 和 25%。还确定了通过自尊和抑郁症状相结合的间接途径（p < .0001)，解释了总效果的 19%。直接影响不显着（p = .524）。结论：ADHD 症状似乎通过自尊和抑郁症状对自杀意念没有直接而是间接的影响。