ADHD-Related Symptom Dimensions and Suicidality After Hospitalization for Bipolar Disorder: A Lebanese Cross-Sectional Survey

Background: Attention-deficit/hyperactivity disorder (ADHD)-related symptoms frequently overlap with bipolar presentations, yet specific symptom dimensions may still carry clinically relevant information about suicidality. Methods: Adults previously hospitalized for bipolar disorder at Hôtel-Dieu de France, Beirut, between 2017 and 2025 completed a single online survey after discharge. The interval after discharge was not standardized. ADHD-related symptoms were screened with the Wender Utah Rating Scale-25 and the Adult ADHD Self-Report Scale; suicidality was assessed with the P4 screener. No formal diagnostic ADHD interview and no standardized measure of current mood state at survey completion were available. Results: Forty-nine participants were included (mean age 35.9 ± 11.9 years; 71.4% women). Suicidality risk was present in 73.5%, WURS-defined probable ADHD in 34.7%, and ASRS Part A positivity in 22.4%. Positive ADHD screens were not significantly associated with suicidality. Participants with suicidality were younger and more likely to report increased alcohol/substance use since hospitalization. In age-adjusted models, higher inattentiveness scores were associated with lower odds of suicidality, whereas higher impulsivity scores were associated with higher odds when the negative mood subdimension was excluded. Conclusions: These preliminary findings suggest that, in bipolar disorder, ADHD-related symptom dimensions may be more informative than a categorical screening result for suicidality. The small sample, variable timing of post-discharge assessment, absence of current mood-state measurement, and use of screening rather than diagnostic ADHD instruments warrant cautious interpretation.