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Anna O, Michael A, Apostolakis M, Mammadov E, Mitka A, Kalatta MA, Koumas M, Georgiou A, Chatzittofis A, Panayiotou G, Gergiou P, Zarate CA, Zanos P. Ketamine and hydroxynorketamine as novel pharmacotherapies for the treatment of Opioid-Use Disorders. Biol Psychiatry 2024:S0006-3223(24)01591-9. [PMID: 39293647 DOI: 10.1016/j.biopsych.2024.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/30/2024] [Accepted: 09/11/2024] [Indexed: 09/20/2024]
Abstract
Opioid use disorder (OUD) has reached epidemic proportions, with many countries facing high opioid use and related fatalities. Although currently-prescribed medications for OUD (MOUD) are considered life-saving, they inadequately address negative affect and cognitive impairment, resulting in high relapse rates to non-medical opioid use, even years after drug cessation (protracted abstinence). Evidence supports the notion that ketamine, an anesthetic and rapid-acting antidepressant drug, holds promise as a candidate for OUD treatment, including the management of acute withdrawal somatic symptoms, negative affect during protracted opioid abstinence and prevention of re-taking non-medical opioids. In this review, we comprehensively discuss preclinical and clinical research evaluating ketamine and its metabolites as potential novel therapeutic strategies for treating OUDs. We further examine evidence supporting the relevance of the molecular targets of ketamine and its metabolites in relation to their potential effects and therapeutic outcomes in OUDs. Overall, existing evidence demonstrates that ketamine and its metabolites can effectively modulate pathophysiological processes affected in OUD, suggesting their promising therapeutic role in the treatment of OUD and the prevention of return to opioid use during abstinence.
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Affiliation(s)
- Onisiforou Anna
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus
| | - Andria Michael
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus
| | - Markos Apostolakis
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus; Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Elmar Mammadov
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201 USA
| | - Angeliki Mitka
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus
| | - Maria A Kalatta
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus
| | - Morfeas Koumas
- Department of Biological Sciences, University of Cyprus, Nicosia, 2109, Cyprus
| | - Andrea Georgiou
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus
| | - Andreas Chatzittofis
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden; Medical School, University of Cyprus, Nicosia, Cyprus
| | - Georgia Panayiotou
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus; Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Polymnia Gergiou
- Department of Psychology, University of Wisconsin-Milwaukee, Wisconsin, 53211, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Panos Zanos
- Department of Psychology, University of Cyprus, Nicosia, 2109, Cyprus; Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201 USA.
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Tisdale C, de Andrade D, Leung J, Campbell G, Hides L. The risk of repeated suicidal presentations following residential treatment for substance use disorders: A recurrent event analysis using linked administrative data. J Affect Disord 2024; 360:364-375. [PMID: 38810779 DOI: 10.1016/j.jad.2024.05.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 05/10/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Individuals seeking alcohol and other drug (AOD) treatment consistently experience higher rates of suicidal behaviours and death by suicide when compared to the general population. By linking residential AOD treatment data to administrative healthcare and death datasets, we aimed to examine suicide-related behaviours and identify risk and protective factors for these events following discharge from residential treatment. METHODS Participants included 1056 individuals aged 18-69 (M = 32.06, SD = 9.55, male = 696,65.9 %) admitted to three residential treatment facilities in Queensland, Australia from January 1, 2014 to December 31, 2016. Treatment data was linked to administrative hospital, emergency department (ED), mental health service, and Registry of Deaths data 2-years post-discharge. ICD-10 codes were used to identify and analyse suicide-related events. RESULTS Within 2-years post-discharge, 175 (16.6 %) individuals had a suicide-related event (n = 298 episodes). The highest proportion of episodes (11.1 %) occurred within 1-month of discharge. Higher risk of a recurrent suicide-related event was associated with receiving a Disability Support Pension (aHR = 1.69 (95%CI:1.10,2.59), two or more previous episodes of residential AOD treatment (aHR = 1.49 (95%CI:1.30,2.15). Completing residential treatment was associated with a lower risk of suicide-related events (aHR = 0.54 (95%CI:0.35,0.83). LIMITATIONS The amalgamation of suicidal ideation, attempts, and death into a single outcome oversimplifies their complex nature and interplay. The exclusive focus on one service provider limits generalisability, and data constraints and missingness preclude many analyses. CONCLUSIONS Understanding suicidal behaviours and critical risk periods following discharge from residential treatment is crucial for improving continuing care, developing effective suicide prevention, and implementing targeted interventions among this high-risk population.
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Affiliation(s)
- Calvert Tisdale
- National Drug and Alcohol Research Centre (NDARC), UNSW Medicine & Health, University of New South Wales, Sydney, Australia; National Centre for Youth Substance Use Research (NCYSUR), School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia.
| | - Dominique de Andrade
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia; Griffith Criminology Institute, Griffith University, Brisbane, Australia; Griffith Centre for Mental Health, Griffith University, Brisbane, Australia; Centre for Drug Use, Addictive, and Anti-social Behaviour Research, Deakin University, Geelong, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research (NCYSUR), School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Gabrielle Campbell
- National Centre for Youth Substance Use Research (NCYSUR), School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Leanne Hides
- National Centre for Youth Substance Use Research (NCYSUR), School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
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Guo Z, Cui Y, Qiu R, Bu L, Yang T, Li Y, Zhu X. The association of impulsivity with depression and anxiety symptoms: A transdiagnostic network analysis and replication. J Affect Disord 2024; 359:100-108. [PMID: 38772504 DOI: 10.1016/j.jad.2024.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Impulsivity increases the risk for depression and anxiety. However, the granular pathways among them remain unknown. A network approach that moves from disorder-level analysis to symptom-level analysis can provide further understanding of psychopathological mechanisms. In this study, we examined the network structure of impulsivity and separate and comorbid symptoms of depression and anxiety. METHODS Regularized partial-correlation networks were estimated using cross-sectional data from 1047 Chinese participants aged 18-26 years (main dataset, mean age = 21.45 ± 2.01 years) and 325 Chinese participants aged 18-36 years (an independent replication dataset, mean age = 21.49 ± 3.73 years), including impulsivity-depression, impulsivity-anxiety, and impulsivity-depression-anxiety networks. The datasets were collected from 1 June 2023 to 4 August 2023 and from 27 April 2022 to 16 May 2022, respectively. Impulsivity, depression, and anxiety were assessed using Barratt Impulsiveness Scale Version 11, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, respectively. Bridge centrality was analyzed, and a network comparison test (NCT) was conducted to investigate the differences between the main dataset and replication dataset. RESULTS The motor impulsivity dimension was revealed to be closely connected with individual symptoms of depression and anxiety regardless of whether they were in separate disorder forms or comorbid forms. In all the networks, motor impulsivity was the most important bridge node. The NCT showed comparable network connectivity and network structure between the main and replication datasets. LIMITATIONS The use of cross-sectional data limited the inferences about the direction of causality between variables. CONCLUSIONS These findings elucidate the psychopathological mechanisms underlying how impulsivity functions within depression, anxiety, and comorbidity and support that motor impulsivity is an important risk factor across different mental disorders and is responsible for comorbidity. The implications of these findings are discussed.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lingbo Bu
- Teaching Evaluation Center, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
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Darabi F, Ziapour A, Ahmadinia H. Motivations for suicide attempts and risk factors among youths in Western Iran: A cross-sectional study. Health Sci Rep 2024; 7:e2297. [PMID: 39118672 PMCID: PMC11306521 DOI: 10.1002/hsr2.2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 07/26/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
Background and Aims Suicide attempts are a fundamental problem in health care systems and are known for their complex and multifaceted nature. This study aimed to explore the reasons for suicide attempts and to identify associated factors in western Iran. Methods In Asadabad, western Iran, a cross-sectional study was carried out between April 2020 and March 2021. A nonrandom sampling method was used to select 110 participants, ages 15-35. Structured questionnaires such as the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI-II), and the Suicide Motivation Scale (IMSA) were used to gather the data. Multiple linear regression, one-way analysis of variance, Pearson's correlation coefficient, and independent t tests were all used in the data analysis. Results The majority of participants (59.1%) were female, with a mean age of 25.78 years. The most common reason for suicide attempts (43.6%) was family issues, and the most popular means (66.4%) were pills and medication. Eighty-nine percent of participants had symptoms of depression. The mean scores were calculated for motivation for suicide attempts (32.46 ± 16.11), depression (34.60 ± 20.50), and anxiety (34.14 ± 15.69). The analysis showed that the motivation for suicide attempts and anxiety was greater in single persons than in married and divorced persons (p < 0.05). Motivation for suicide attempts was also greater in low- to middle-income individuals with a history of divorce (p < 0.05). The multiple regression model showed that anxiety, sex, education, and medical history significantly influenced the motivation for suicide attempts (p < 0.001). Conclusion The results showed that a wide range of social, economic, and cultural factors and psychiatric disorders, including anxiety and depression, are involved in suicide attempts. This study aimed to design interventions and strategies to prioritize mental health, improve life skills to control stressful events, and focus on high-risk groups (women, married people, people with low education levels, and those with a history of physical and mental illnesses) for suicide prevention in health promotion programs.
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Affiliation(s)
- Fatemeh Darabi
- Department of Public HealthAsadabad School of Medical SciencesAsadabadIran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam‐Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Hassan Ahmadinia
- Department of Epidemiology and Biostatistics, School of Health, Occupational Environment Research CenterRafsanjan University of Medical SciencesRafsanjanIran
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Sönmez İ. How Does Sexual Identity-Attraction Discordance Influence Suicide Risk? A Study on Male and Female Adults in the U.S. Arch Suicide Res 2024; 28:686-700. [PMID: 37303190 DOI: 10.1080/13811118.2023.2220757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Suicide continues to be one of the main causes of death among adults in the U.S. Research showed an association between sexual identity-attraction discordance (IAD) and adverse health outcomes, including suicidal ideation. METHODS We sought to determine whether sexual IAD is associated with self-injurious thoughts and behaviors (SITBs), namely suicidal thoughts, plans, and suicide attempts, in the past year. We examined data from adults participating in the most recent six waves (2015-2020) of the National Survey on Drug Use and Health. RESULTS Men who report sexual identity-attraction discordance were at greater risk of reporting suicidal thoughts (aOR = 3.67, 95% CI: 2.24-6.00) and plans (aOR = 5.71, 95% CI: 3.32-9.81) in the past year. Stratified by sexual identity, results showed that gay (aOR = 5.92, 95% CI: 1.54-22.7) and bisexual men (aOR = 4.38, 95% CI: 2.17-8.83) had higher odds of reporting suicide plans and heterosexual (aOR = 2.66, 95% CI: 1.06-6.68), gay (aOR = 7.05, 95% CI: 1.88-26.4), and bisexual men (aOR = 5.30, 95% CI: 4.37-22.9) had higher odds of suicide attempts when compared to men with concordant sexual identity-attraction. We found that bisexual women who report sexual identity-attraction discordance had less odds of reporting suicidal thoughts (aOR = 0.36, 95% CI: 0.21-0.63) and suicide plans (aOR = 0.43, 95% CI: 0.20-0.89) than women with concordant sexual identity-attraction. Among bisexual-identified males, those who experience sexual identity-attraction discordance were at greater risk for past-year suicidal thoughts (aOR = 3.82, 95% CI: 2.12-6.91) and suicide attempts (aOR = 5.30, 95% CI: 2.13-13.1) when compared to bisexual men with concordant sexual identity-attraction. CONCLUSION Sexual IAD is associated with SITB and particularly concerning results emerged concerning bisexual-identified men.
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Leza L, Haro B, López-Goñi JJ, Fernández-Montalvo J. Substance use disorder and lifetime suicidal behaviour: A scoping review. Psychiatry Res 2024; 334:115830. [PMID: 38432115 DOI: 10.1016/j.psychres.2024.115830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Suicidal behaviours are prevalent in substance use disorder (SUD) patients. These behaviours have a negative impact on the psychopathological profile of these patients. However, few studies have evaluated suicide as a continuum (i.e. starting with ideation, followed by attempts and ending with death) and its evolution during treatment. The aim of this scoping review was to explore what is known about suicidal behaviour in individuals undergoing clinical treatment for SUD. METHODS The PsycINFO, Web of Science (Core Collection and MEDLINE), Scopus, and Cochrane Library databases were searched. After screening the records based on eligibility and exclusion criteria, 30 studies were ultimately selected for inclusion. RESULTS Most of the studies were conducted in the USA and Europe. Only three studies evaluated suicidal behaviour with a specific instrument. The prevalence of suicidal ideation (SI) in people being treated for SUD ranged from 20 % to 62.2 %, and the prevalence of suicide attempts (SA) ranged from 15.8 % to 52.1 %. Only one study reported death by suicide. CONCLUSIONS Despite the high prevalence of suicidal behaviours and their harmful consequences, the assessment of this phenomenon is scarce and heterogeneous. There is a need to assess suicidal behaviour with standardized criteria in order to develop tailored SUD treatment.
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Affiliation(s)
- Leire Leza
- Departament of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona 31006, Spain.
| | - Begoña Haro
- Departament of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona 31006, Spain
| | - José J López-Goñi
- Departament of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona 31006, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Javier Fernández-Montalvo
- Departament of Health Sciences, Universidad Pública de Navarra, Campus de Arrosadía, Pamplona 31006, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
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Grote V, Wagner T, Riedl D, Kautzky-Willer A, Fischer MJ, Scheibenbogen O, Musalek M. Female Patients Show a Larger Reduction in Suicidal Ideation in Inpatient Addiction Treatment Than Male Patients: Results of a Single-Center Observational Study. Subst Abuse Rehabil 2024; 15:31-42. [PMID: 38567036 PMCID: PMC10986415 DOI: 10.2147/sar.s454436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
Background Substance use disorders (SUD) are prevalent disorders worldwide. Among other associated health problems, patients with SUD are at an increased risk of dying of suicide, with females displaying an even higher risk than males. Therefore, the aim of this study was to conduct a gender-sensitive evaluation of changes in suicidal ideation during multimodal inpatient treatment at a hospital facility specialized in treating addiction. Methods A total of 694 patients (68.2% male) completed routine assessment including suicidal ideation, abstinence confidence, impulsivity, emotion regulation, self-efficacy and autonomy and joy both before (T1) and at the end (T2) of treatment. Mean changes were evaluated with repeated measures MANOVAs. Results Before treatment, a total of n=127 (18.3%) of the respondents reported suicidal ideation, which was reduced to n=72 (10.4%) by the end of treatment. Among female patients, the change in reported suicidal ideation compared from T1 to T2 (21.7% vs 7.7%) was significantly higher than among male patients (T1: 16.7%%, T2: 11.6%; p=0.040). Generally, females reported worse symptoms scores and slightly higher numbers of suicidal thoughts at baseline (effect sizes ranging from η²=.008 - 0.044). While both genders significantly profited from the treatment, female patients generally showed larger improvements than male. Discussion Our study underscores the beneficial effect of addiction-specialized inpatient treatment on suicidal ideation. Additionally, we found a substantial gender effect: while female patients generally were more distressed before treatment, they also reported higher symptom reduction during the treatment. This result highlights the need to perform more gender-sensitive research and develop more gender-sensitive treatment programs.
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Affiliation(s)
- Vincent Grote
- Ludwig Boltzmann Institute for Rehabilitation Research, Ludwig Boltzmann Gesellschaft, Vienna, Austria
| | - Tim Wagner
- Ludwig Boltzmann Institute for Rehabilitation Research, Ludwig Boltzmann Gesellschaft, Vienna, Austria
- Anton Proksch Institute, Vienna, Austria
| | - David Riedl
- Ludwig Boltzmann Institute for Rehabilitation Research, Ludwig Boltzmann Gesellschaft, Vienna, Austria
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Michael J Fischer
- Ludwig Boltzmann Institute for Rehabilitation Research, Ludwig Boltzmann Gesellschaft, Vienna, Austria
- Vamed Rehabilitation Center Kitzbühel, Kitzbühel, Austria
- Clinic for Rehabilitation Medicine, Hannover Medical School MHH, Hannover, Germany
| | | | - Michael Musalek
- Department of General Psychiatry, Sigmund Freud University, Vienna, Austria
- Institute for Social Aesthetics and Mental Health, Sigmund Freud University, Vienna, Austria
- Institute for Social Aesthetics and Mental Health, Sigmund Freud University, Berlin, Germany
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Diefenbach GJ, Stubbing J, Rice TB, Lord KA, Rudd MD, Tolin DF. Uncovering the role of substance use in suicide attempts using a mixed-methods approach. Suicide Life Threat Behav 2024; 54:70-82. [PMID: 37987548 DOI: 10.1111/sltb.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Substance use is an established risk factor for suicide attempt. Clarifying the role of substance use in suicide attempts may identify modifiable treatment targets. This study used mixed methods to associate substance use with suicide attempt history and identify pathways through which substance use contributes to attempts. METHODS Study 1 included 213 adult inpatients (n = 127 with substance use disorder [SUD]), who completed assessments of suicide attempt history as well as demographic and clinical suicide risk factors. Study 2 was a narrative analysis of suicide attempt stories described by 20 inpatients diagnosed with SUD. RESULTS In Study 1, patients with co-occurring alcohol and drug use disorders reported more actual lifetime suicide attempts than did those without SUD. In addition, alcohol and drug use disorders were independently associated with lifetime suicide attempts after controlling for demographic and clinical confounders. In Study 2, substance use played a role in all suicide attempts through at least one pathway before, during, or after a triggering stressor, or as suicide attempt method. CONCLUSIONS Substances play a role in suicide attempt baseline risk, acute risk and as means. It is important to target chronic and acute substance use in suicide prevention treatment plans.
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Affiliation(s)
- Gretchen J Diefenbach
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jessica Stubbing
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | - Tyler B Rice
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | - Kayla A Lord
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | | | - David F Tolin
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
- Yale University School of Medicine, New Haven, Connecticut, USA
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Abbasi-Ghahramanloo A, Jafarzadeh M, Pourfarzi F, Afrashteh S, Azimi A, Yusuf MA, Adham D, Moradi-Asl E. Characteristics of suicide attempts in Northwestern Iran: a five-year population-based survey. BMC Psychiatry 2024; 24:15. [PMID: 38166930 PMCID: PMC10763457 DOI: 10.1186/s12888-023-05483-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Suicide is a serious public health problem in the world. This study aims to describe the characteristics of suicide attempters in North-Western Iran and identify latent classes of suicide attempts. METHODS This cross-sectional study was conducted in Ardabil Province (Northwest Iran) during 2017-2021 based on a registration system for suicide attempts. We performed latent class analysis (LCA) using a procedure for LCA (PROC LCA) in SAS to investigate the subgroups of suicide attempters based on their characteristics and method, history, and outcome of suicide. RESULTS Three latent classes were identified for males and females; the first class (non-lethal attempters with lower educational levels) comprised 41.3% of males and 55.4% of females. The second class (non-lethal attempters with higher educational levels) described 52.4% of males and 42.7% of females. Finally, the third class (lethal attempters) included 6.4% of males and 1.9% of females. The main method of suicide attempts was poisoning with medications (87.3%). The results show that only 2.8% of people have a history of suicide attempts. Also, the suicide rate reached 8.26 per 100,000 population in 2021. CONCLUSION The present study showed an increasing trend of suicide attempt incidence rate in Ardabil Province from 2017 (99.49 per 100,000 population) to 2021 (247.41 per 100,000 population). This means that the rate of change was 147.92 per 100,000 population during the study period. The findings of LCA, stress the necessity of identification and prioritization of unmet needs of people who had an incomplete suicide in Ardabil.
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Affiliation(s)
- Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Jafarzadeh
- CDC of Ardabil Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farhad Pourfarzi
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sima Afrashteh
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ahad Azimi
- CDC of Ardabil Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mustpha Ahmed Yusuf
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, Kano, Nigeria
| | - Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Eslam Moradi-Asl
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
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Fernández SD, Miranda JJF, Pastor FP, Muñoz FL. Gender and addiction and other mental disorders comorbidity: sociodemographic, clinical, and treatment differences. Arch Womens Ment Health 2023; 26:639-650. [PMID: 37540344 PMCID: PMC10491505 DOI: 10.1007/s00737-023-01353-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
The co-occurrence of substance use disorders (SUD) and other mental disorders (OMD) is assumed to be high, but the details are uncertain in Spain. The objective of the present study was to know the prevalence of this comorbidity, as well as the pharmacological treatment, both in specific addiction treatment networks and in mental health networks, with a gender perspective. Observational, multicenter study, with a randomized sample, of patients under treatment for SUD or OMD in Spain (N = 1783). A specific questionnaire, collecting sociodemographic and clinical variables, diagnosed SUD and OMD, and prescribed psychotropic drugs, was completed by treating clinicians. Differences between females and males were searched. A high prevalence of OMD was found in those patients treated for their SUD (71%), and also of diagnoses of SUD (59%) in people treated for OMD. Significant relationships between addiction to certain substances and specific mental disorders were found (with no main differences between women and men). The treatments for OMD were very common in the addiction treatment networks, but that of SUDs in those patients treated in the mental health networks was less than expected. A high prescription of benzodiazepines was found. Women were less frequently diagnosed with cannabis, opioid, and especially cocaine use disorders, and they had fewer psychotic disorders and more affective, anxiety, sleep, and eating disorders, with the rest being the same, including personality disorders. Women had fewer treatments with agonists and more with antagonists, and more prescriptions of anxiolytics and antidepressants. This study provides preliminary information on the coexistence in routine clinical practice of addictive disorders and other mental disorders in Spain, and on the treatment provided, and shows differences in prevalence and clinical characteristics, and especially in treatment approaches between women and men. Thus, should be useful to adapt the treatment response with greater precision, and with a gender perspective.
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Affiliation(s)
- Silvia Díaz Fernández
- Asturian Mental Health Service Area V- Hospital Univ. Cabueñes, Servicio de Salud del Principado de Asturias (SESPA), Gijón, Spain.
- Asturian Institute on Health Research (Instituto para la Investigación Sanitaria del P° de Asturias-ISPA), Oviedo, Spain.
| | - Juan José Fernandez Miranda
- Asturian Mental Health Service Area V- Hospital Univ. Cabueñes, Servicio de Salud del Principado de Asturias (SESPA), Gijón, Spain
- Asturian Institute on Health Research (Instituto para la Investigación Sanitaria del P° de Asturias-ISPA), Oviedo, Spain
| | - Francisco Pascual Pastor
- Unidad de conductas adictivas, Servicio Valenciano de Salud (SVS), Alcoi, Spain
- PREVENGO, University Miguel Hernández, Elche, Spain
| | - Francisco López Muñoz
- Faculty of Health Sciences, University Camilo José Cela, Madrid, Spain
- Neuropsychopharmacology Unit, Hospital 12 de Octubre Research Institute, Madrid, Spain
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Palma-Álvarez RF, Daigre C, Ros-Cucurull E, Perea-Ortueta M, Ortega-Hernández G, Ríos-Landeo A, Roncero C, Ramos-Quiroga JA, Grau-López L. Clinical features and factors related to lifetime suicidal ideation and suicide attempts in patients who have had substance-induced psychosis across their lifetime. Psychiatry Res 2023; 323:115147. [PMID: 36913874 DOI: 10.1016/j.psychres.2023.115147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023]
Abstract
Suicidal behaviors are common among patients with substance use disorders (SUD). However, the prevalence and clinical factors related to suicide behaviors among patients who have had substance-induced psychosis (SIP) is unknown. This study aims to explore the prevalence, clinical features, and factors related to lifetime suicidal ideation (SI) and suicide attempts (SA) in patients who have had SIP across their lifetime. A cross-sectional study was conducted in an outpatient center for addiction treatment between 01/01/2010 and 12/31/2021. 601 patients were evaluated with validated scales and questionnaires (79.03% males; M age 38.11±10.11 years). The prevalence of SI and SA was 55.4% and 33.6%, respectively. SI was independently related to any type of lifetime abuse, depressive spectrum disorders, benzodiazepine use disorder, borderline personality disorder, and the level of depressive symptoms. SA was independently associated with lifetime physical abuse, benzodiazepine use disorder, the number of psychotic symptoms, borderline personality disorder, and the level of depressive symptoms. The main factors related to SI and SA in those patients should be evaluated in daily clinical practice and considered in any approach to clinical practice as well as in health policies targeting suicide prevention.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Germán Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Ana Ríos-Landeo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain; Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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12
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Grove JL, April LY, Evan MK. Social Support as Protective Factor for Suicidal Ideation during Treatment for Substance Abuse: Differential Effects across Treatment Modalities. CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2022. [DOI: 10.1016/j.crbeha.2022.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Siria S, Leza L, López-Goñi JJ, Fernández-Montalvo J. Lifetime suicidal-related behaviour among patients in treatment for substance use disorder: A cross-sectional study. Psychiatry Res 2022; 317:114921. [PMID: 37732864 DOI: 10.1016/j.psychres.2022.114921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 10/31/2022]
Abstract
Suicidal-related behaviours are an important concern in individuals who present with substance use disorders (SUDs). The distinction among the specific characteristics of the different patients might help to improve prevention strategies. We describe and compare the sociodemographic characteristics, severity of addiction, and psychopathology of the participants depending on the severity of their lifetime suicidal behaviour. In addition, we examine whether the number of suicide attempts can be estimated based on the variables that differentiate the groups. A sample of 318 men and 86 women who sought treatment for addiction were assessed. The sample was divided into: no ideation or attempts, suicidal ideation, one suicide attempt, and two or more suicide attempts. The group with two or more suicide attempts exhibited a greater severity in the addiction profile. The group with one suicide attempt presented a higher psychopathological symptomatology at the time of the assessment. The severity of the Psychiatric area was related to the group with two or more attempts and to the number of suicide attempts. The presence of any number of attempts is associated with greater severity of addiction. Providing specific intervention strategies for SUD patients depending on their suicidal behaviours is promising for clinical application.
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Affiliation(s)
- Sandra Siria
- Universidad del País Vasco (UPV/EHU). San Sebastián. Guipúzcoa Spain
| | - Leire Leza
- Departamento de Ciencias de la Salud. Universidad Pública de Navarra. Campus de Arrosadía, 31006 Pamplona. Spain
| | - José J López-Goñi
- Departamento de Ciencias de la Salud. Universidad Pública de Navarra. Campus de Arrosadía, 31006 Pamplona. Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. Navarra. Spain.
| | - Javier Fernández-Montalvo
- Departamento de Ciencias de la Salud. Universidad Pública de Navarra. Campus de Arrosadía, 31006 Pamplona. Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. Navarra. Spain
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14
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Andersson HW, Mosti MP, Nordfjærn T. Suicidal ideation among inpatients with substance use disorders: Prevalence, correlates and gender differences. Psychiatry Res 2022; 317:114848. [PMID: 36116184 DOI: 10.1016/j.psychres.2022.114848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 01/04/2023]
Abstract
We examined the prevalence of suicidal ideation (SI) among inpatients with substance use disorders (SUD) and investigated the association between SI and demographic (age, education, gender) and clinical factors (SUD, psychiatric disorders, anxiety/depression symptoms, substance use onset age). We collected medical record data including types of ICD-10 SUD and psychiatric diagnoses (i.e. mood: F30-39; anxiety: F40-48; personality: F60-F60.9; F61.0; F62; ADHD: F90-F90.9) and patient-reported data from 563 patients admitted to inpatient SUD treatment. Lifetime SI was measured by one question from the Addiction Severity Index (ASI). Gender differences in SI rates were examined using Chi-square tests. To determine variables that were uniquely associated with SI we conducted hierarchical regression analyses. The overall prevalence of SI was 50%, and it occurred more frequently among females (61.9%) than males (45.4%). SI was associated with female gender, younger age of substance use onset, mood and personality disorders, and higher anxiety/depression symptoms. Male gender accounted for the significant association between younger age of onset and SI. Diagnostic information on mood and personality disorders, and screening of patient-reported anxiety/depression symptoms at treatment intake may be useful for clinicians in identifying and providing personalized treatment for SUD inpatients who are at increased risk of SI.
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Affiliation(s)
- Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Pb 3250 Sluppen, Trondheim 7006, Norway.
| | - Mats P Mosti
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Pb 3250 Sluppen, Trondheim 7006, Norway
| | - Trond Nordfjærn
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Pb 3250 Sluppen, Trondheim 7006, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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15
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Brynte C, Aeschlimann M, Barta C, Begeman AHA, Bäcker A, Crunelle CL, Daigre C, De Fuentes-Merillas L, Demetrovics Z, Dom G, López LG, Icick R, Johnson B, Joostens P, Kapitány-Fövény M, Karsinti E, Kiefer F, Konstenius M, Levin FR, Luderer M, Markus W, Matthys F, Moggi F, Palma-Alvarez RF, Paraskevopoulou M, Ramos-Quiroga JA, Schellekens A, Soravia LM, Therribout N, Thomas A, van de Glind G, van Kernebeek MW, Vollstädt-Klein S, Vorspan F, van den Brink W, Franck J. The clinical course of comorbid substance use disorder and attention deficit/hyperactivity disorder: protocol and clinical characteristics of the INCAS study. BMC Psychiatry 2022; 22:625. [PMID: 36151539 PMCID: PMC9502646 DOI: 10.1186/s12888-022-04259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Substance use disorders (SUD) often co-occur with attention deficit hyperactivity disorder (ADHD). Although the short-term effects of some specific interventions have been investigated in randomized clinical trials, little is known about the long-term clinical course of treatment-seeking SUD patients with comorbid ADHD. AIMS This paper presents the protocol and baseline clinical characteristics of the International Naturalistic Cohort Study of ADHD and SUD (INCAS) designed and conducted by the International Collaboration on ADHD and Substance Abuse (ICASA) foundation. The overall aim of INCAS is to investigate the treatment modalities provided to treatment-seeking SUD patients with comorbid ADHD, and to describe the clinical course and identify predictors for treatment outcomes. This ongoing study employs a multicentre observational prospective cohort design. Treatment-seeking adult SUD patients with comorbid ADHD are recruited, at 12 study sites in nine different countries. During the follow-up period of nine months, data is collected through patient files, interviews, and self-rating scales, targeting a broad range of cognitive and clinical symptom domains, at baseline, four weeks, three months and nine months. RESULTS A clinically representative sample of 578 patients (137 females, 441 males) was enrolled during the recruitment period (June 2017-May 2021). At baseline, the sample had a mean age (SD) of 36.7 years (11.0); 47.5% were inpatients and 52.5% outpatients; The most prevalent SUDs were with alcohol 54.2%, stimulants 43.6%, cannabis 33.1%, and opioids 14.5%. Patients reported previous treatments for SUD in 71.1% and for ADHD in 56.9%. Other comorbid mental disorders were present in 61.4% of the sample: major depression 31.5%, post-traumatic stress disorder 12.1%, borderline personality disorder 10.2%. CONCLUSIONS The first baseline results of this international cohort study speak to its feasibility. Data show that many SUD patients with comorbid ADHD had never received treatment for their ADHD prior to enrolment in the study. Future reports on this study will identify the course and potential predictors for successful pharmaceutical and psychological treatment outcomes. TRIAL REGISTRATION ISRCTN15998989 20/12/2019.
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Affiliation(s)
- Christoffer Brynte
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden.
| | - Myriam Aeschlimann
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Csaba Barta
- grid.11804.3c0000 0001 0942 9821Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Budapest, Hungary
| | | | - Amanda Bäcker
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Cleo Lina Crunelle
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Constanza Daigre
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Laura De Fuentes-Merillas
- grid.491352.8Novadic-Kentron Addiction Care; Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Zsolt Demetrovics
- grid.5591.80000 0001 2294 6276Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary ,grid.513141.30000 0004 4670 111XCentre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Geert Dom
- grid.5284.b0000 0001 0790 3681University of Antwerp, Antwerp, Belgium ,PC Multiversum, Boechout, Belgium
| | - Lara Grau López
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Romain Icick
- grid.508487.60000 0004 7885 7602Université de Paris Cité, Paris, France
| | | | | | - Máté Kapitány-Fövény
- grid.11804.3c0000 0001 0942 9821Faculty of Health Sciences, Semmelweis University, Budapest, Hungary ,National Institute of Mental Health, Neurology and Neurosurgery – Nyírő Gyula Hospital, Budapest, Hungary
| | - Emily Karsinti
- grid.414095.d0000 0004 1797 9913Université Paris-Nanterre, CliPsyD Laboratory FR and APHP, Fernand Widal Hospital, Universitary Department of Psychiatry and Addictology, Paris, France
| | - Falk Kiefer
- grid.7700.00000 0001 2190 4373Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maija Konstenius
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Frances R. Levin
- grid.21729.3f0000000419368729Vagelos College of Physicians and Surgeons, New York City, USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York City, USA
| | - Mathias Luderer
- grid.411088.40000 0004 0578 8220Department of Psychiatry, Psychosomatic Medicine and Psychoterapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Wiebren Markus
- grid.491352.8Iriszorg Addiction Care, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Frieda Matthys
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Franz Moggi
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry, Translational Research Center, University of Bern, Bern, Switzerland
| | - Raul Felipe Palma-Alvarez
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Maria Paraskevopoulou
- Department of Psychiatry, RadboudumcDonders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - J. Antoni Ramos-Quiroga
- grid.411083.f0000 0001 0675 8654Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d’Hebron, Barcelona, Spain ,grid.430994.30000 0004 1763 0287Psychiatry Group, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Biomedical Network Research Centre On Mental Health (CIBERSAM), Madrid, Spain ,grid.7080.f0000 0001 2296 0625Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Arnt Schellekens
- Department of Psychiatry, RadboudumcDonders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands ,grid.491352.8Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, the Netherlands
| | - Leila M. Soravia
- grid.5734.50000 0001 0726 5157University Hospital of Psychiatry, Translational Research Center, University of Bern, Bern, Switzerland ,Südhang Clinic, Kirchlindach, Switzerland
| | - Norman Therribout
- grid.414095.d0000 0004 1797 9913Université Paris-Nanterre, CliPsyD Laboratory FR and APHP, Fernand Widal Hospital, Universitary Department of Psychiatry and Addictology, Paris, France
| | - Anil Thomas
- Mt. Sinai, Icahn School of Medicine, New York City, USA ,grid.137628.90000 0004 1936 8753NYU Grossman School of Medicine, New York City, USA
| | - Geurt van de Glind
- grid.438049.20000 0001 0824 9343University of Applied Sciences-Utrecht, Utrecht, the Netherlands
| | - Michiel Willem van Kernebeek
- grid.411326.30000 0004 0626 3362Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, 1090 Jette, Belgium
| | - Sabine Vollstädt-Klein
- grid.7700.00000 0001 2190 4373Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Florence Vorspan
- grid.508487.60000 0004 7885 7602Université de Paris Cité, Paris, France
| | - Wim van den Brink
- grid.509540.d0000 0004 6880 3010Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Johan Franck
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
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Kassie GM, Lemu YM, Biresaw MS, Dessie GM, Tadesse GT, Gared WM, Belay MW. Suicidal ideation and attempt and associated factors among patients with substance use disorder: institution-based cross-sectional study. BJPsych Open 2022; 8:e150. [PMID: 35912979 PMCID: PMC9380183 DOI: 10.1192/bjo.2022.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND No published research in Ethiopia has examined the prevalence of suicidal ideation and suicide attempts and associated factors among patients with substance use disorder. AIMS The main aim of this study was to assess the prevalence of suicidal ideation, suicide attempt and associated factors among patients with substance use disorders. METHOD An institution-based cross-sectional study was conducted from 5 May to 13 June 2019 in Addis Ababa. A total of 408 patients were identified using a systematic sampling technique. Data were collected through interviews using the suicidality module of the Composite International Diagnostic Interview. Data were entered into EpiData and analysed using SPSS. Logistic regression analyses were employed. Variables with P < 0.05 were considered to be statistically significant with 95% confidence intervals. RESULTS Prevalence rates of suicidal ideation and attempt were found to be 39.5% and 18.6%, respectively. Family history of mental illness (adjusted odds ratio (AOR) = 3.60, 95% CI: 2.17, 5.97), comorbid mental illness (AOR = 3.61, 95% CI: 2.11, 6.16), perceived stigma related to substance misuse (AOR = 4.00, 95% CI: 2.26, 7.07) and alcohol use (AOR = 7.49, 95% CI: 1.99, 28.19) were associated with suicidal ideation. Being female (AOR = 2.46, 95% CI: 1.08, 5.70), family history of suicide (AOR = 3.08, 95% CI: 1.68, 5.64), comorbid mental illness (AOR = 4.09, 95% CI: 2.23, 7.49) and khat use (AOR = 3.73, 95% CI: 1.24, 11.17) were associated with suicide attempt. CONCLUSIONS The prevalence of suicidal ideation and attempt were both found to be high. In particular, patients who had a comorbid mental illness were at high risk of both suicidal ideation and attempt. Therefore, special attention should be given to those with a family history of suicide or comorbid mental illness.
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Affiliation(s)
- Gebeyaw Molla Kassie
- Department of Psychiatry, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Yohanes Mirekena Lemu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu Biresaw
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | | | - Woredaw Minichil Gared
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mesele Wonde Belay
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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17
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Daneshmend AZB, Stewart J, Jarkas DA, Franklyn SI, Gabrys RL, Patterson ZR, Abizaid A, Hellemans KGC, McQuaid RJ. Examining Risk Factors in the Cannabis–Suicide Link: Considering Trauma and Impulsivity among University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159307. [PMID: 35954661 PMCID: PMC9368410 DOI: 10.3390/ijerph19159307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 02/07/2023]
Abstract
Cannabis is a commonly used substance among university students that may have several negative health repercussions, including suicidal ideation (SI) and suicide attempts (SA). The factors that contribute to or help explain this relation remain uncertain. Earlier negative experiences, especially trauma encountered during early life, have been associated with the development of psychopathology upon later stressor encounters. In the current study, we examined the associations between SI and SA with problematic cannabis use among young adults and the role of earlier trauma experiences and trait impulsiveness in understanding this link. Among university students (N = 539), problematic cannabis use was moderately related to lifetime and past-12-months suicidal ideation and attempts. Impulsiveness mediated the relationship between problematic cannabis use and lifetime SI and SA. Moreover, previous life trauma moderated the relationship between problematic cannabis use and SA, such that the association between problematic cannabis use and SA was stronger among those who experienced high levels of trauma. These findings highlight behavioral and environmental factors that could predict suicide ideation and attempts among young cannabis users. Accordingly, trait impulsiveness and early trauma experiences should be considered, alongside problematic cannabis use, in suicide-risk detection and prevention strategies among young adults.
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Affiliation(s)
- Ayeila Z. B. Daneshmend
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON K1Z 7K4, Canada
- Correspondence:
| | - Jayme Stewart
- Department of Psychology, Carleton University, Ottawa, ON KIS 5B6, Canada; (J.S.); (S.I.F.)
| | - Dana A. Jarkas
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON K1Z 7K4, Canada
| | - Sabina I. Franklyn
- Department of Psychology, Carleton University, Ottawa, ON KIS 5B6, Canada; (J.S.); (S.I.F.)
| | - Robert L. Gabrys
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
| | - Zachary R. Patterson
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
| | - Alfonso Abizaid
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
| | - Kim G. C. Hellemans
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
| | - Robyn J. McQuaid
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada; (D.A.J.); (R.L.G.); (Z.R.P.); (A.A.); (K.G.C.H.); (R.J.M.)
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON K1Z 7K4, Canada
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Chai Y, Luo H, Wei Y, Chan SKW, Man KKC, Yip PSF, Wong ICK, Chan EW. Risk of self-harm or suicide associated with specific drug use disorders, 2004-2016: a population-based cohort study. Addiction 2022; 117:1940-1949. [PMID: 35112757 DOI: 10.1111/add.15820] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 01/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Drug use disorders are associated with increased risk of self-harm. Risk differences associated with specific types of drug use disorders are yet to be comprehensively reported. This study aimed to examine the risk of self-harm or suicide associated with different drug use disorders in Hong Kong. DESIGN Population-based cohort study. SETTING The Clinical Data Analysis and Reporting System (CDARS) managed by the Hong Kong Hospital Authority. PARTICIPANTS Cases were people ages 10 years or older who visited a hospital Accident and Emergency department between 1 January, 2004 and 31 December, 2016 with any of 10 specific drug use disorders (comprising opioid; ketamine; methamphetamine; sedative, hypnotic, or anxiolytic; amphetamine or related stimulant; cocaine; cannabis; hallucinogen; unspecified or other drug; and polydrug). Each case was matched with two controls, selected from a subset of people in CDARS sharing the same gender, age and psychiatric profile. A total of 8270 cases and 16 540 matched controls were included. MEASUREMENTS Incidence and adjusted hazard ratio (aHR) of subsequent self-harm or suicide for each specific drug use disorder were estimated. FINDINGS The most prevalent drug use disorder was opioid use disorder (2523; 30.51%) and the least prevalent was hallucinogen use disorder (77; 0.93%). The crude incidence of self-harm or suicide ranged from 26.57 (95% CI, 14.23-44.55) per 1000 person-years for cannabis use disorder to 91.97 (77.32-108.37) for polydrug use disorder. The highest risk of self-harm or suicide was observed in ketamine (aHR, 16.36; 95% CI, 11.03-24.29) and opioid (15.97; 10.73-23.23) use disorders. CONCLUSIONS In Hong Kong, all types of drug use disorders appear to be significantly associated with increased risk of self-harm or suicide, but risk levels vary by type of drug use disorder.
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Affiliation(s)
- Yi Chai
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China.,Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong SAR, China
| | - Yue Wei
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sherry K W Chan
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.,Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kenneth K C Man
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
| | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China.,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
| | - Esther W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Ibrahim AS, Bayomy RH, Hussein RA, Yousef UM, Elazab WE. Some psychiatric comorbidity among patients with substance abuse disorder related to pregabalin. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00204-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pregabalin abuse is increasing worldwide and frequently comorbid with another psychiatric disorders including generalized anxiety, major depression, personality disorders, and suicide. Eighty-three patients meeting DSM-IV criteria for substance abuse disorders related to pregabalin were identified from the addiction clinic of El Khanka Psychiatric Hospital in Egypt for this observational cross-sectional study. We aimed to assess clinical characteristics of substance abuse disorder related to pregabalin, suicidal ideation, and psychiatric comorbidities associated with them. All participants were subjected to semi-structured interview designed to collect and identify the sociodemographic data and patterns of substances use, the Structured Clinical Interview for DSM-IV axis I disorders to diagnose comorbid major depression and generalized anxiety, Structured Clinical Interview for DSM-IV axis II disorders for diagnosis of borderline and antisocial personality disorders, Addiction Severity Index, Beck Depressive Inventory, Hamilton Anxiety Rating Scale, and Beck Scale for Suicidal Ideation and urine screening test for pregabalin and other substances.
Results
Forty-seven percent of the studied group had generalized anxiety disorder, 74.7% had major depression disorder, some patients had both major depression and generalized anxiety disorders, 78.3% had borderline personality disorder, 37.3% had antisocial personality disorder, and some patients had both borderline and antisocial personality disorders. There was a statistically significant increase in suicidal ideation among subjects with major depression, generalized anxiety, previous suicidal attempts, and borderline personality disorder.
Conclusions
There is a high comorbidity between pregabalin abuse and major depression disorder, generalized anxiety disorder, borderline personality disorder, and antisocial personality disorder. These psychiatric comorbidities were associated with high risk of suicidal ideations.
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Keyes D, Talarico P, Hardin B, Molter A, Lee H, Valiuddin H, Moore B. Suicidal ideation and sobriety: Should acute alcohol intoxication be taken into account for psychiatric evaluation? Alcohol Clin Exp Res 2022; 46:1306-1312. [PMID: 35581530 DOI: 10.1111/acer.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND When evaluating an emergency department (ED) patient who presents with suicidal ideation, it is a common practice to wait until the patient's ethanol level is known or calculated to be less than 80 mg/dl to evaluate patient safety. We know of no study that establishes an association between the degree of alcohol intoxication based on a blood alcohol level (BAL) and reported suicidal ideation (SI) upon recovery. METHODS We conducted a retrospective review of patients evaluated in a Midwestern ED for the calendar year 2017. Cases were selected if they had a psychiatric social work consult and a blood alcohol level drawn while in the ED. Patients were selected on the same 2 days each week throughout the year to meet the sample size requirements of the study, resulting in 1084 cases for review. Chi-square analysis was used to evaluate the relationship between suicidal ideation and alcohol intoxication as defined by a BAL ≥80 mg/dl. RESULTS Among patients presenting with suicidal ideation and a concurrent BAL ≥80 mg/dl, 69% no longer reported suicidal ideation when their BAL was <80 mg/dl, compared to 38% for patients without a positive BAL on presentation (chi-square, p = 0.000012). CONCLUSION Our data show that patients presenting to the ED with complaints related to suicidal behavior who have a BAL ≥80 mg/dl are more likely to no longer endorse having suicidal ideation once their BAL is < 80 mg/dl than patients with similar presenting complaints and no alcohol intoxication. This finding supports the common ED practice of re-assessing suicidal ideation among individuals who are initially intoxicated once their BAL has decreased below 80 mg/dl.
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Affiliation(s)
- Daniel Keyes
- College of Osteopathic Medicine, Michigan State University, Lansing, Michigan, USA.,GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Departments of Emergency Medicine and Psychiatry, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Natural Sciences, College of Arts Sciences and Letters, University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Philip Talarico
- Meadville Medical Center, Mind Body Wellness Center, Meadville, Pennsylvania, USA
| | - Blake Hardin
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Natural Sciences, College of Arts Sciences and Letters, University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Alexander Molter
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA
| | - Honesty Lee
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA
| | - Hisham Valiuddin
- Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brandon Moore
- Departments of Emergency Medicine and Psychiatry, Trinity Health Livonia Hospital, Livonia, Michigan, USA
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21
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Fleury MJ, Grenier G, Cao Z, Huỳnh C, Chihade D. Predictors of Emergency Department Use for Suicidal Behaviors among Patients with Substance-Related Disorders. Arch Suicide Res 2022; 27:796-817. [PMID: 35499529 DOI: 10.1080/13811118.2022.2066591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aimed to identify predictors of emergency department (ED) use for suicide ideation or suicide attempt compared with other reasons among 14,158 patients with substance-related disorders (SRD) in Quebec (Canada). METHODS Longitudinal data on clinical, sociodemographic, and service use variables for patients who used addiction treatment centers in 2012-13 were extracted from Quebec administrative databases. A multinomial logistic regression was produced, comparing predictors of suicide ideation or attempts to other reasons for ED use in 2015-16. RESULTS Patients using ED for both suicide ideation and attempt were more likely to have bipolar or personality disorders, problems related to the social environment, 4+ previous yearly outpatient consultations with their usual psychiatrist, high prior ED use, and dropout from SRD programs in addiction treatment centers in the previous 7 years, compared with those using ED for other reasons. Patients with alcohol- or drug-related disorders other than cannabis and living in the least materially deprived areas, urban territories, and university healthcare regions made more suicide attempts than those using ED for other reasons. Patients with common mental disorders, 1-3 previous yearly outpatient consultations with their usual psychiatrist, one previous treatment episode in addiction treatment centers, and those using at least one SRD program experienced more suicide ideation than patients using ED for other reasons. CONCLUSION Clinical variables most strongly predicted suicidal behaviors, whereas completion of SRD programs may help to reduce them. SRD services and outreach strategies should be reinforced, particularly for patients with complex issues living in more advantaged urban areas. HIGHLIGHTSOver 10% of ED visits were for suicidal behaviors among patients with SRD.ED use for suicidal behaviors was mainly associated with clinical variables.Addiction treatment centers may help reduce ED use for suicidal behaviors.
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22
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Roncero C, Pérez J, Molina J, Quintano JA, Campuzano AI, Pérez J, Miravitlles M. Frequency and Associated Factors of Suicidal Ideation in Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2022; 11:2558. [PMID: 35566685 PMCID: PMC9101437 DOI: 10.3390/jcm11092558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to examine the prevalence of suicidal ideation in patients with chronic obstructive pulmonary disease (COPD) and the association between demographic and clinical variables and the occurrence of suicidal thoughts. This was a cross-sectional study. Sociodemographic and clinical data were recorded, and questionnaires were used to assess depressive symptoms (Beck Depression Inventory), comorbidities (Charlson Index), cognitive performance (Mini Mental State Examination), and quality of life (EuroQoL-5 dimensions and CAT). Specific questions about suicide-related behavior were included. Multivariate logistic regression analysis identified the significant factors associated with previous suicidal ideation and suicide attempts. The analysis included 1190 subjects. The prevalence of suicidal ideation and suicide attempts were 12.1% and 2.5%, respectively. Severely depressed patients had the highest prevalence of suicide-related behavior. The adjusted logistic model identified factors significantly associated with suicidal ideation: sex (odds ratio (OR) for women vs. men = 2.722 (95% confidence interval (CI) = 1.771-4.183)), depression score (OR = 1.163 (95% IC = 1.127-1.200)), and Charlson Index (OR 1.228 (95% IC 1.082-1.394)). Suicidal ideation is common in COPD patients, especially in women. While addressing suicidal ideation and suicide prevention, clinicians should first consider the management of depressive symptomatology and the improvement of coping strategies.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Joselín Pérez
- Medical Department, Grupo Ferrer, 08029 Barcelona, Spain; (J.P.); (A.I.C.)
| | - Jesús Molina
- Centro de Salud Francia, Dirección Asistencial Oeste, 28993 Madrid, Spain;
| | | | | | - Javier Pérez
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Marc Miravitlles
- Department of Pneumology, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
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23
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Ferreira ACZ, Capistrano FC, Kaled M, Maftum MA, Kalinke LP, Palm RDCM, Miasso AI. Tentativa de suicídio por pessoas com transtornos relacionados ao uso de substâncias em tratamento. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.38798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: identificar os fatores associados à tentativa de suicídio por pessoas com transtornos relacionados ao uso de substâncias em tratamento nos Centros de Atenção Psicossocial de Álcool e outras Drogas. Método: estudo observacional e transversal realizado com 137 pessoas com transtornos relacionados ao uso de substâncias em tratamento em Centros de Atenção Psicossocial de Álcool e outras Drogas de uma capital da região Sul do Brasil. Os dados foram coletados entre abril e novembro de 2018 por entrevista estruturada e submetidos à análise quantitativa descritiva, univariada e múltipla. Resultados: 51,8% dos participantes apresentaram ao menos uma tentativa de suicídio alguma vez na vida. Pensamentos suicidas ativos com intenção e com planejamento permaneceram associadas de modo independente ao histórico de tentativa de suicídio (RP: 2,87; IC: 1,04-7,91; p: 0,041). Na análise univariada houve associação entre tentativa de suicídio e dias de problema físico, intensidade dos pensamentos suicidas, comportamento preparatório, sentimentos depressivos, histórico familiar de transtorno mental, internamento em hospital psiquiátrico, importância de tratamento em saúde mental e prescrição de medicamentos. Conclusão: mais gravidade de pensamentos suicidas foi identificada como fator associado ao histórico de tentativa de suicídio. Enfatiza-se a importância da escuta ativa na prática profissional em saúde, do vínculo terapêutico e do acolhimento nos serviços de atenção à saúde.
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24
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Mindfulness and Negative Emotions Among Females Who Inject Drugs: the Mediating Role of Social Support and Resilience. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00812-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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25
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Lee WC, Chang HM, Huang MC, Pan CH, Su SS, Tsai SY, Chen CC, Kuo CJ. All-cause and suicide mortality among people with methamphetamine use disorder: a nation-wide cohort study in Taiwan. Addiction 2021; 116:3127-3138. [PMID: 33788344 DOI: 10.1111/add.15501] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/12/2021] [Accepted: 03/17/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Although methamphetamine use is a serious public health problem, large-scale cohort studies assessing methamphetamine-related mortality are scant. This study investigated all-cause mortality and suicide methods in people with methamphetamine use disorder. DESIGN A cohort record-linkage study using data from Taiwan's National Health Research Institute Database (NHIRD) linked to Taiwan's National Death Certification System. SETTING Taiwan. PARTICIPANTS A total of 23 248 individuals with methamphetamine use disorder between 1 January 2001 and 31 December 2005. MEASUREMENTS The outcome variables included mortality rates and standardized mortality ratios (SMRs) for all causes of death and for each suicide method. FINDINGS Compared with the general population, the current cohort had an increased all-cause mortality (SMR = 5.4), with the SMR for unnatural causes (14.8) higher than that for natural causes (7.5). Among all causes of death, suicide had the highest SMR (16.3), followed by neurological diseases (9.7). Among the methods of choice for suicide, drug overdose had the highest SMR (24.9). The incidence of charcoal burning and hanging was significantly higher in men and that of jumping from a high place was significantly higher in women. CONCLUSION People in Taiwan with methamphetamine use disorder appear to have a significantly increased all-cause mortality rate compared with the general population, with suicide having the highest contribution, particularly suicide via drug overdose. The methods of choice for suicide revealed distinct patterns between men and women.
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Affiliation(s)
- Wan-Chen Lee
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Chyi Huang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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26
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Zhu H, Yao J, Fan H, Wang Q, Wang X, Gao Q. Prevalence and risk factors of suicidal ideation in adult inpatients with five different types of mental disorders. J Affect Disord 2021; 291:344-351. [PMID: 34087630 DOI: 10.1016/j.jad.2021.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/13/2021] [Accepted: 05/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Suicide is a major but preventable public health problem in the world. Mental disorders are related to suicide, and can predict suicidal ideation (SI). This study aims to compare the differences in the prevalence and risk factors of SI among patients with five types of mental disorders. METHODS This study involved adult inpatients with five types of mental disorders in Beijing Anding Hospital. Text mining was used to extract information from the electronic medical records. We performed the Pearson's Chi-square analysis and multivariable unconditional logistic regression to filter factors to assess odds of SI for each type of mental disorders. RESULTS Of the 21,287 participants included, 2,619 had experienced SI. For both sexes, the highest risk of SI was found for patients with recurrent depressive disorder (OR = 7.096; P <.001), followed by patients with depressive episode and bipolar affective disorder when comparing with those with substance use disorder. Gender, age, occupation, drinking, single child, personal relationship, family history of mental disorder, family history of suicide and psychological trauma were associated with SI after adjusting for confounding factors, but the risk factors and their effects in each type were different. LIMITATIONS The clear causal associations between mental disorders and SI cannot be elucidated. In addition, the ability to study the predictors of SI is constrained by the fact that the sample excluded people who completed suicide. CONCLUSIONS SI is common and distinct strategies should be taken in suicide prevention for patients with different types of mental disorders.
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Affiliation(s)
- Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing 100069, China
| | - Jiangyue Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing 100069, China
| | - Hua Fan
- Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China
| | - Qian Wang
- Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China
| | - Xiangran Wang
- Zhongshan Securities Company Limited, Shenzhen, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing 100069, China.
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27
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Icick R, Bloch V, Prince N, Karsinti E, Lépine JP, Laplanche JL, Mouly S, Marie-Claire C, Brousse G, Bellivier F, Vorspan F. Clustering suicidal phenotypes and genetic associations with brain-derived neurotrophic factor in patients with substance use disorders. Transl Psychiatry 2021; 11:72. [PMID: 33479229 PMCID: PMC7820499 DOI: 10.1038/s41398-021-01200-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 06/13/2020] [Accepted: 07/03/2020] [Indexed: 11/09/2022] Open
Abstract
Suicide attempts (SA), especially recurrent SA or serious SA, are common in substance use disorders (SUD). However, the genetic component of SA in SUD samples remains unclear. Brain-derived neurotrophic factor (BDNF) alleles and levels have been repeatedly involved in stress-related psychopathology. This investigation uses a within-cases study of BDNF and associated factors in three suicidal phenotypes ('any', 'recurrent', and 'serious') of outpatients seeking treatment for opiate and/or cocaine use disorder. Phenotypic characterization was ascertained using a semi-structured interview. After thorough quality control, 98 SNPs of BDNF and associated factors (the BDNF pathway) were extracted from whole-genome data, leaving 411 patients of Caucasian ancestry, who had reliable data regarding their SA history. Binary and multinomial regression with the three suicidal phenotypes were further performed to adjust for possible confounders, along with hierarchical clustering and compared to controls (N = 2504). Bayesian analyses were conducted to detect pleiotropy across the suicidal phenotypes. Among 154 (37%) ever suicide attempters, 104 (68%) reported at least one serious SA and 96 (57%) two SA or more. The median number of non-tobacco SUDs was three. The BDNF gene remained associated with lifetime SA in SNP-based (rs7934165, rs10835210) and gene-based tests within the clinical sample. rs10835210 clustered with serious SA. Bayesian analysis identified genetic correlation between 'any' and 'serious' SA regarding rs7934165. Despite limitations, 'serious' SA was shown to share both clinical and genetic risk factors of SA-not otherwise specified, suggesting a shared BDNF-related pathophysiology of SA in this population with multiple SUDs.
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Affiliation(s)
- Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Paris, France. .,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France. .,Université de Paris, Inserm UMR-S1144, Paris, France.
| | - Vanessa Bloch
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Nathalie Prince
- grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Emily Karsinti
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,ED139, Paris Nanterre University, Nanterre, France
| | - Jean-Pierre Lépine
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Jean-Louis Laplanche
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France
| | - Stéphane Mouly
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Cynthia Marie-Claire
- grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Georges Brousse
- grid.494717.80000000115480420Inserm UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Frank Bellivier
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
| | - Florence Vorspan
- grid.50550.350000 0001 2175 4109Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis–Lariboisière–Fernand Widal, Paris, France ,grid.7429.80000000121866389INSERM U1144, “Therapeutic Optimization in Neuropsychopharmacology”, Paris, France ,Université de Paris, Inserm UMR-S1144, Paris, France
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Federico A, Mantovani E, Casari R, Bertoldi A, Lugoboni F, Tamburin S. Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction and quality of life in high-dose use of benzodiazepine and Z-drug. J Neural Transm (Vienna) 2020; 128:1109-1119. [PMID: 33331955 PMCID: PMC8295124 DOI: 10.1007/s00702-020-02285-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022]
Abstract
High-dose use of benzodiazepines (BZDs) and Z-drugs was found to be associated with adult attention deficit/hyperactivity disorder (ADHD) and multidomain cognitive deficits, but the interplay between these factors and its effect on quality of life (QoL) is unclear. We explored (a) whether cognitive dysfunction differs in high-dose BZD/Z-drug users with and without adult ADHD and (b) the impact of cognitive deficits and adult ADHD on QoL in this substance-use disorder (SUD). From January 2015 to December 2019, we recruited 207 high-dose BZD/Z-drug users seeking treatment. We assessed the presence of adult ADHD with a screening tool, which was validated in SUD patients, and collected demographic, clinical and QoL data from the 76 included patients. A neuropsychological battery explored five cognitive domains. We found that: (a) screening for adult ADHD was frequently positive; (b) Short Form-36 (SF-36), a self-administered QoL questionnaire, was worse than the general population and worse in patients positive (ADHD+) vs. those negative (ADHD−) to ADHD screening tool; (c) executive function was significantly worse in ADHD+ than ADHD− patients; (d) some SF-36 dimensions were negatively influenced by executive dysfunction; (e) multivariate analysis showed an interplay between adult ADHD and cognitive dysfunction in worsening QoL. We documented a complex interplay between adult ADHD, cognitive dysfunction and QoL in high-dose BZD/Z-drug users. Assessing adult ADHD, neuropsychological measures and QoL may offer a full scenario of these patients, who are frequently impaired in everyday activities. Future research should explore whether pharmacological treatment might improve cognitive dysfunction and QoL in this SUD.
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Affiliation(s)
- Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Rebecca Casari
- Addiction Medicine Unit, Department of Medicine, Verona University Hospital, Piazzale Scuro 10, Verona, Italy
| | - Anna Bertoldi
- Addiction Medicine Unit, Department of Medicine, Verona University Hospital, Piazzale Scuro 10, Verona, Italy
| | - Fabio Lugoboni
- Addiction Medicine Unit, Department of Medicine, Verona University Hospital, Piazzale Scuro 10, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
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Ramírez EGL, Delgado YK, Volpato RJ, de Claudio JCM, Pinho PH, de Vargas D. Suicidal ideation in gender and sexual minority students in the largest Brazilian University. Arch Psychiatr Nurs 2020; 34:467-471. [PMID: 33280668 DOI: 10.1016/j.apnu.2020.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/22/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Identifying the presence of suicidal ideation and associated factors among university students from a public university in Brazil. METHODS A cross-sectional study was performed with 72 university students between 18 and 29 years old. Were used a sociodemographic data questionnaire and the Beck's Suicidal Ideation Scale. RESULTS The suicidal ideation was significantly in the participants, as well as the association of gender, gender identity, sexual orientation and housing with it. CONCLUSIONS The suicidal ideation in this population is important, and there is a need to explore the factors related, such as gender, sexual orientation, gender identity and housing.
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Affiliation(s)
| | | | | | | | | | - Divane de Vargas
- School of Nursing, University of São Paulo (USP), São Paulo, SP, Brazil
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30
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Epidemiologic Characteristics of Suicide in Panama, 2007–2016. Medicina (B Aires) 2020; 56:medicina56090442. [PMID: 32878148 PMCID: PMC7559330 DOI: 10.3390/medicina56090442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 08/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: We aim to describe the demographic characteristics associated with suicide in Panama, to estimate the suicide mortality rate and years of potential life lost (YPLL) to suicide, and to explore the correlation of suicide rates with the Multidimensional Poverty Index (MPI). We present a descriptive retrospective epidemiological report of suicide-related mortality (Panama, 2007–2016). Materials and Methods: Data were matched-merged to calculate unadjusted suicide mortality rates (overall, and by sex, age groups, and administrative region), YPLL, and coefficients (r) for the correlation of MPI and suicide rates. Results: There were 1475 deaths by suicide (86% among men, 47% between 20 and 39 years). The average mortality rate was estimated at 3.91 per 100,000 population with an average YPLL rate of 3.79 per 1000 population. There was a statistically significant trend to reduce YPLL over time (r = −0.93; p< 0.001). Exploratory analyses did not show a significant correlation between the MPI and suicide rates. Our study showed a 6:1 male-to-female ratio of suicide, mostly affecting the age groups of 20–29 and over 80 years. Conclusions: Exploratory analyses on the correlation of the MPI and the suicide rates did not achieve statistical significance, and alternative explanations, such as access to pesticides and alcohol, were further explored to inform potential interventions.
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31
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Vergara-Moragues E, González-Saiz F. Predictive Outcome Validity of General Health Questionnaire (GHQ-28) in Substance Abuse Patients Treated in Therapeutic Communities. J Dual Diagn 2020; 16:218-227. [PMID: 31608803 DOI: 10.1080/15504263.2019.1674465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: The use of psychoactive substances has been one of the most important global public health problems over the last few decades. Among the problems associated with substance use, dual diagnosis is one of the most relevant. This study aims to investigate the predictive validity of the GHQ-28 (General Health Questionnaire-28; "probable psychiatric cases") in relation to poor treatment outcome measured by (a) "early treatment dropout" and (b) "nonclinically relevant improvement at discharge." Methods: A longitudinal prospective design was used. A sample of 219 substance use disorder patients, who received treatment in a therapeutic community, was selected. Patients were assessed using the GHQ-28 and the outcome variables were registered. A hierarchical logistic regression model was performed to identify factors independently associated with the outcome measure ("early treatment dropout" and "nonclinically relevant improvement at discharge"). Results: Of the total sample, 79 subjects (36%) were considered "early treatment dropouts" and 56.6% (102) presented a "nonclinically relevant improvement at discharge." The two hierarchical logistic regression results show that being classified as a "probable psychiatric case" was significantly and directly associated with "early treatment dropout" and "nonclinically relevant improvement at discharge," as a poor in-treatment outcome indicator. Conclusions: The results of this study support the notion that the probable psychiatric cases identified by the GHQ-28 scale have a greater probability of "early treatment dropout" and have a greater probability of "nonclinically relevant improvement in discharge" of the therapeutic community. These data indicate that GHQ-28 is a suitable clinical instrument for predicting dropout and treatment effect in residential substance use disorder treatment.
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Affiliation(s)
- Esperanza Vergara-Moragues
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - Francisco González-Saiz
- Unidad de Salud Mental Comunitaria de Jerez, UGC Salud Mental, Área de Gestión Sanitaria Norte de Cádiz, Servicio Andaluz de Salud, Cádiz, Spain.,Departamento de Neurociencias, Área de Psiquiatría, Universidad de Cádiz, Cádiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
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32
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Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractSuicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
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33
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Martinotti G, Negri A, Schiavone S, Montemitro C, Vannini C, Baroni G, Pettorruso M, De Giorgio F, Giorgetti R, Verrastro V, Trabace L, Garcia A, Castro I, Iglesias Lopez J, Merino Del Villar C, Schifano F, di Giannantonio M. Club Drugs: Psychotropic Effects and Psychopathological Characteristics of a Sample of Inpatients. Front Psychiatry 2020; 11:879. [PMID: 33110412 PMCID: PMC7488956 DOI: 10.3389/fpsyt.2020.00879] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/11/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Growing evidence supports the possibility of significant psychiatric consequences related to novel and traditional psychoactive substance consumption. The problem of differential diagnosis has hampered research on specific psychopathologies with unclear outcomes. The aim of our study was to report psychiatric and clinical features of subjects admitted to a psychiatric ward in Ibiza, Spain, with a clinical diagnosis of substance abuse or intoxication. METHODS A survey was administered to a sample of inpatients hospitalized due to psychiatric symptoms related to recent use of psychoactive substances. The questionnaire investigated sociodemographic factors, familiar and personal anamnesis, substance use habits, general and psychopathological features. Urine samples were collected and analyzed in a toxicology laboratory using gas chromatography and mass spectrometry. RESULTS A total of 110 patients were included in the study. Most patients (70%) declared multiple substance use, and 33% of patients reported more than two substances; nevertheless, it was possible to identify 17 (15%) depressor users, 44 (40%) stimulant users and 49 (45%) psychodysleptics users. A positive association with a lifetime diagnosis of bipolar disorder was found (two-tailed Fisher's exact test: p = 0.013). Psychomotor agitation, reference, and paranoid delusions, affective symptoms, consciousness disorders, and aggressiveness represented some of the most frequent symptoms at entry evaluation. CONCLUSIONS In this study, we described the acute psychiatric presentations related to recreational drug use in subjects on holiday in Ibiza. The use of psychoactive substances was characterized by poly-use of both traditional and novel substances, with several psychopathological consequences. Future research should focus on a better understanding of the psychopathological effects of specific substances, defining signs and symptoms to help make a differential diagnosis and prospectively examine long-term effects.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy.,Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Attilio Negri
- Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom.,Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Montemitro
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Chiara Vannini
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Gaia Baroni
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Fabio De Giorgio
- Section of Legal Medicine, Department of Health Care Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Raffaele Giorgetti
- Section of Legal Medicine, Department of Excellence SBSP, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Valeria Verrastro
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | | | | | - Fabrizio Schifano
- Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging, Clinical Sciences, University G.d'Annunzio Chieti-Pescara, Chieti, Italy
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34
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Lugoboni F, Bertoldi A, Casari R, Mantovani E, Morbioli L, Tamburin S. Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users. Eur Addict Res 2020; 26:274-282. [PMID: 32570244 DOI: 10.1159/000507852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Problematic high-dose benzodiazepine (BZD) and related Z-drug use for a long period is a substance use disorder previously found to be associated with adult attention-deficit/hyperactivity disorder (ADHD) and worse quality of life (QoL). Whether adult ADHD impacts QoL in high-dose BZD/Z-drug users has not been explored. AIM The aim of the study was to explore the impact of adult ADHD on QoL in high-dose BZD and related Z-drug users. METHODS We recruited 393 patients (205 men and 188 women) consecutively admitted to the Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Italy, from July 2016 to July 2019 for detoxification from high-dose BZD or Z-drug dependence. Demographic and clinical variables and QoL measures were recorded. The World Health Organization ADHD Self-Report Scale version 1.1 Symptom Checklist Part A was used to detect adult ADHD. RESULTS In our sample, 39.4% of patients were positive to adult ADHD testing (ADHD+), with some clinical features differing in comparison to patients negative to ADHD testing (ADHD-). QoL was worse in high-dose BZD/Z-drug users than the general population. The ADHD+ group showed significantly worse QoL measures than the ADHD- group. Multivariate analysis, including potential covariates showed adult ADHD and age to have the most robust and consistent positive effect for age (i.e., higher QoL) and negative effect for ADHD (i.e., lower QoL) on QoL measures. CONCLUSIONS Adult ADHD is associated with worse QoL measures in high-dose BZD/Z-drug users. Future studies should explore whether appropriate BZD/Z-drug detoxification might improve QoL measures and whether the most appropriate detoxification protocol differs in ADHD+ versus ADHD- populations.
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Affiliation(s)
- Fabio Lugoboni
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Anna Bertoldi
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Rebecca Casari
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Laura Morbioli
- Department of Medicine, Addiction Medicine Unit, Verona University Hospital, Verona, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy,
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35
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Alho H, Dematteis M, Lembo D, Maremmani I, Roncero C, Somaini L. Opioid-related deaths in Europe: Strategies for a comprehensive approach to address a major public health concern. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 76:102616. [PMID: 31855706 DOI: 10.1016/j.drugpo.2019.102616] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 11/07/2019] [Accepted: 12/03/2019] [Indexed: 12/28/2022]
Abstract
Use of illicit opioids and misuse of prescription opioids are the main causes of drug-related deaths across the world, and the continuing rise in opioid-related mortality, especially affecting North America, Australia and Europe, is a public health challenge. Strategies that may help to decrease the high levels of opioid-related mortality and morbidity and improve care across Europe include risk assessment and interventions to improve the use of opioid analgesics, e.g. prescription drug-monitoring programmes, education on pain management to reduce opioid prescribing, and the implementation of evidence-based primary prevention programmes to reduce the demand for opioids. For patients who develop opioid use disorder (a chronic and relapsing problematic use of opioids that causes clinical impairment or distress), treatment combining opiate receptor full or partial agonist medications for opioid-use disorder (MOUD) with psychosocial interventions is essential. However, in Europe a substantial proportion of the 1.3 million high-risk opioid users (defined as injecting drug use or regular use of opioids, mainly heroin) remain outside of dedicated treatment programmes. More widespread and easier access to MOUD could reduce mortality levels; via approaches such as primary care-led treatment models, and efforts to improve patient retention and adherence to treatment programmes. Other harm-reduction strategies, such as the use of MOUD at optimal doses, the provision of take-home naloxone, the introduction of supervised drug-consumption facilities, and patient education to reduce the risk of overdose may also be beneficial.
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Affiliation(s)
- Hannu Alho
- Department of Public Health Solutions, The Alcohol, Drugs and Addictions Unit, National Institute of Health and Welfare, Mannerheimintie 166, Helsinki, Finland.
| | - Maurice Dematteis
- Department of Addiction Medicine, Grenoble Alpes University Hospital and Faculty of Medicine, Grenoble Alpes University, France.
| | | | - Icro Maremmani
- Vincent P. Dole Dual Disorder Unit, Santa Chiara University Hospital, University of Pisa, Italy.
| | - Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex and Psychiatric Department, University of Salamanca, Salamanca, Spain.
| | - Lorenzo Somaini
- Addiction Treatment Centre, Local Health Unit, Biella, Italy.
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Coryell W, Fiedorowicz J, Solomon D, Endicott J, Keller M. Anxiety Symptom Severity and Long-term Risk for Suicidal Behavior in Depressive Disorders. Suicide Life Threat Behav 2019; 49:1621-1629. [PMID: 31131922 DOI: 10.1111/sltb.12555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We have previously shown that the severity of anxiety symptoms during major depressive episodes is associated in a linear fashion with the proportion of weeks in depressive episodes during a subsequent 25 years of follow-up. Here, we test whether the negative prognostic implications of anxiety comorbidity extend to higher likelihoods of suicidal behavior. METHODS We used the NIMH Collaborative Depression Study (CDS) cohort to test both the severity of eight anxiety symptoms and the presence or absence of four anxiety disorders as risk factors for suicide attempts or completions over a mean (SD) follow-up of 16.6 (8.5) years. Separate analyses tested potential predictors of events that occurred within 2 years and those that occurred later. RESULTS None of the baseline anxiety manifestations were significantly associated with overall risks for past or future suicide attempts. Only the diagnosis of phobic disorder was overrepresented in the 36 who committed suicide. Psychic anxiety was a risk factor for suicide attempts beyond 2 years of follow-up, and phobic anxiety was protective of suicides within this period. CONCLUSIONS These results did not show anxiety comorbidity to be an important risk factor for suicide attempts or completions.
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Affiliation(s)
- William Coryell
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Jess Fiedorowicz
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - David Solomon
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Jean Endicott
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Martin Keller
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
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Black J, Bond MA, Hawkins R, Black E. Test of a clinical model of poor physical health and suicide: The role of depression, psychosocial stress, interpersonal conflict, and panic. J Affect Disord 2019; 257:404-411. [PMID: 31306991 DOI: 10.1016/j.jad.2019.05.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/08/2019] [Accepted: 05/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study employed a structural equation model to examine the relationships between poor physical health, suicide, depression, psychosocial stress, interpersonal conflict, and panic. METHODS The sample consisted of a large, archived set of mental health treatment-seeking adults who completed a behavioral outcome questionnaire prior to beginning treatment. RESULTS Results supported the extant literature indicating that poor physical health, depression, psychosocial stress, interpersonal conflict, and panic impose increased risk for suicidal ideation, with depression demonstrating the highest risk for increased suicidal ideation. The results also supported the hypotheses that depression, psychosocial stress, interpersonal conflict, and panic would mediate the association between poor physical health and suicidal ideation. Although no a priori hypotheses were made regarding relationships among the 15 physical illnesses examined, results indicated that HIV/AIDS had the strongest correlation with depression and the weakest correlation with interpersonal conflict. LIMITATIONS Firstly, the study sample was primarily Caucasian, limiting its generalizability. Secondly, causal inferences should be interpreted with caution, due to the quasi-experimental design. Thirdly, these data were self-reported, which create response biases since suicidal ideation is stigmatized. CONCLUSIONS These findings highlight the importance of considering interpersonal factors as potential mediators in the relationship between poor physical health, mental illness, and suicide. Clinically, the impact of an active major depressive episode on an individual who is struggling with a serious physical illness may be strongly predictive of suicidal ideation.
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Affiliation(s)
- Janie Black
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND).
| | - Mark A Bond
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND)
| | - Raymond Hawkins
- Department of Psychology, the University of Texas at Austin, United States
| | - Elizabeth Black
- Elizabeth A. Black: MSN Candidate, School of Nursing, University of Texas at Austin, United States
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38
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de la Torre-Luque A, Essau CA. Symptom network connectivity in adolescents with comorbid major depressive disorder and social phobia. J Affect Disord 2019; 255:60-68. [PMID: 31128506 DOI: 10.1016/j.jad.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Major depressive disorder (MDD) and social phobia (SP) are both common and highly co-occurring psychiatric disorders. This study used symptom network analysis approach to examine comorbidity structure and the complex symptom dynamics which may play a role in the co-occurrence of MDD and SP. METHOD Data comes from the National Comorbidity Survey - Adolescent Supplement, a nationally representative survey of adolescents ages 13 to 18 years. This study examined data of adolescents with a lifetime diagnosis of MDD (n = 597), SP (n = 708), and adolescents with comorbid MDD and SP (n = 189). Networks were estimated by means of 26 symptoms from both disorders. RESULTS All MDD and SP symptoms were involved in the network of both pure disorders (MDD; SP) and comorbid condition (MDD + SP). Network structure was different between the pure disorders (p = 0.014), but not when comparing each of these disorders that have comorbid condition. Depressive symptoms of poor self-esteem and suicidal symptoms were central (i.e., showed a higher influence) in the symptom network for the pure disorders and for the comorbid condition. Other key symptoms in the comorbid condition network were two depressive symptoms: feelings of worthlessness and anhedonia. SP and MDD networks showed two common key SP symptoms: feeling uncomfortable when meeting new people and feeling uncomfortable talking to people do not know well. CONCLUSION The study of symptom dynamics will provide useful targets for preventing the development of comorbid disorders as well as new lines of intervention to deal with key symptoms of psychiatric disorders.
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Affiliation(s)
| | - Cecilia A Essau
- Department of Psychology, University of Roehampton, Whitelands College, Holybourne Avenue, London SW15 4JD, UK.
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39
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The tide does turn: Predictors of remission from suicidal ideation and attempt among Canadians who previously attempted suicide. Psychiatry Res 2019; 274:313-321. [PMID: 30836277 DOI: 10.1016/j.psychres.2019.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
The objectives of this study were to identify factors that contribute to (1) remission from suicidal ideation, and (2) remission from suicide attempt, among Canadians with a lifetime history of suicide attempt. Data for this study came from Statistics Canada's nationally representative 2012 Canadian Community Health Survey-Mental Health. A sample of 769 adult respondents who had ever attempted suicide was analyzed with remission from past year suicidal ideation and remission from past year suicide attempt as outcome variables. Of the 769 respondents who had ever attempted suicide, more than two-thirds (69%) were free from suicidal ideation within the past year, and approximately 87% were free from suicide attempts within the past year. Compared to men, odds were 2.66 times greater for women to be free of suicide attempt and 2.65 times greater to be free of suicidal ideation in the past year. Older age, being free of sleep problems and major depressive episode, having no history of chronic childhood physical abuse, and having two or fewer previous suicide attempts were associated with higher odds of remission from both suicide attempt and ideation in the past year.
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40
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Carrasco-Farfan CA, Alvarez-Cutipa D, Vilchez-Cornejo J, Lizana-Medrano M, Durand-Anahua PA, Rengifo-Sanchez JA, Rebatta-Acuña A, Cubas WS, Arroyo-Hernandez H, Toro-Huamanchumo CJ. Alcohol consumption and suicide risk in medical internship: A Peruvian multicentric study. Drug Alcohol Rev 2019; 38:201-208. [PMID: 30681212 DOI: 10.1111/dar.12897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIM Suicide and harmful alcohol consumption are major health problems, especially in medical students. This study aimed to evaluate the association between risk for alcohol abuse and suicide risk in medical interns of Peruvian hospitals. DESIGN AND METHODS We conducted a multicentre cross-sectional study in medical interns from 18 Peruvian hospitals. We measured suicide risk, risk for alcohol abuse, depression and self-esteem using the Plutchik Suicide Risk Scale, CAGE, Zung Self-Rating Depression Scale and Rosenberg Self-Esteem Scale, respectively. We used χ2 and Student t-tests for descriptive analysis. To evaluate the association between risk for alcohol abuse and suicide risk we generated crude and adjusted Poisson regression models with robust variance and estimated prevalence ratios with 95% confidence intervals. RESULTS We surveyed 433 medical interns. The prevalence of suicide risk and risk for alcohol abuse was 19.6% and 27.5%, respectively. We found significant differences in suicide risk according to age (P < 0.001), region of origin (P = 0.002), with whom the participant lived (P < 0.001), university of origin (P = 0.040), type of hospital (P = 0.042), family history of attempted suicide (P = 0.043), self-esteem level (P < 0.001) and alcohol consumption (P < 0.001). In the adjusted model, age (PRa: 1.11, 95% confidence interval 1.05-1.17) and risk for alcohol abuse (PRa: 7.60, 95% confidence interval 4.46-12, 96) were associated with suicide risk. DISCUSSION AND CONCLUSIONS Two out of 10 medical interns had a positive screening for suicide risk. Age and especially risk for alcohol abuse were the associated variables.
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Affiliation(s)
| | | | | | | | | | | | | | - Wildor S Cubas
- School of Medicine, Universidad Nacional de San Martin, Tarapoto, Peru
| | | | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
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López-Goñi JJ, Fernández-Montalvo J, Arteaga A, Haro B. Suicidal attempts among patients with substance use disorders who present with suicidal ideation. Addict Behav 2019; 89:5-9. [PMID: 30237111 DOI: 10.1016/j.addbeh.2018.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/24/2018] [Accepted: 09/05/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Patients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction problems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and to explore the differential characteristics for suicide ideators with and without suicide attempts. METHODS A sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed. MEASUREMENTS Information concerning socio-demographic characteristics, addiction severity, and psychopathological symptoms was obtained. RESULTS In total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%-47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to everyday life than patients with only suicidal ideation. Specifically, three psychopathological variables were related to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium. CONCLUSIONS According to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition.
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Palma-Álvarez RF, Rodríguez-Cintas L, Abad AC, Sorribes M, Ros-Cucurull E, Robles-Martínez M, Grau-López L, Aguilar L, Roncero C. Mood Disorders and Severity of Addiction in Alcohol-Dependent Patients Could Be Mediated by Sex Differences. Front Psychiatry 2019; 10:343. [PMID: 31214056 PMCID: PMC6554686 DOI: 10.3389/fpsyt.2019.00343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 05/01/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Alcohol dependence is highly prevalent in the general population; some differences in alcohol use and dependence between women and men have been described, including outcomes and ranging from biological to social variables. This study aims to compare the severity of alcohol dependence with clinical and psychopathological characteristics between sexes. Methods: A cross-sectional descriptive study was conducted in alcohol-dependent outpatients; the recruitment period was 7 years. The assessment of these patients was carried out by obtaining sociodemographic characteristics and using the Semi-structured Clinical Interview for Axis I and II (SCID-I and SCID-II), European version of the Addiction Severity Index (EuropASI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) scales. Variables were compared and analyzed. Results: The sample was composed of 178 patients (74.2% males and 25.8% females) with a mean age of 46.52 ± 9.86. No sociodemographic differences were found between men and women. Females had a higher rate of suicide attempts and depression symptoms at the treatment onset. When results of EuropASI were compared, females had worse psychological and employment results than males. According to consumption variables, males had an earlier onset of alcohol use, had more regular alcohol use, and develop alcohol dependence earlier than females. Conclusions: According to results, there are sex-dependent differences (severity and other variables such as mood or suicide) in alcohol dependence. Thus, this may implicate the need of future specific research and treatment programs based on the specific necessities of each sex.
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Affiliation(s)
- Raul F Palma-Álvarez
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Laia Rodríguez-Cintas
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Alfonso C Abad
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Marta Sorribes
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain
| | - Elena Ros-Cucurull
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | | | - Lara Grau-López
- Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital-Public Health Agency, Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònomade Barcelona, Barcelona, Spain
| | - Lourdes Aguilar
- Psychiatry Service, Salamanca University Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
| | - Carlos Roncero
- Psychiatry Service, Salamanca University Health Care Complex, Institute of Biomedicine, University of Salamanca, Salamanca, Spain
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Mallorquí-Bagué N, Mena-Moreno T, Granero R, Vintró-Alcaraz C, Sánchez-González J, Fernández-Aranda F, Pino-Gutiérrez AD, Mestre-Bach G, Aymamí N, Gómez-Peña M, Menchón JM, Jiménez-Murcia S. Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity. J Behav Addict 2018; 7:1112-1121. [PMID: 30580545 PMCID: PMC6376371 DOI: 10.1556/2006.7.2018.132] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/13/2018] [Accepted: 11/24/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) presents high rates of suicidality. The combined influences of emotion dysregulation and trait impulsivity are crucially important (albeit understudied) for developing strategies to treat GD and prevent suicide attempts. The aim of this study is to investigate the association between trait impulsivity, emotion dysregulation, and the dispositional use of emotion regulation (ER) strategies with suicidal ideation and psychopathological symptom severity in GD. METHODS The sample composed of 249 patients with GD (166 with suicidal ideation) who underwent face-to-face clinical interviews and completed questionnaires to assess psychopathological symptoms, impulsive traits, and ER. RESULTS Patients with GD who presented suicidal ideation were older and had a later age of GD onset and higher GD severity. Analyses of variance showed higher comorbid symptoms, emotion dysregulation, and trait impulsivity in patients with suicidal ideation. Still, no significant differences were found in the use of ER strategies. SEM analysis revealed that a worse psychopathological state directly predicted suicidal ideation and that both emotion dysregulation and GD severity indirectly increased the risk of suicidal ideation through this state. High trait impulsivity predicted GD severity. Finally, a history of suicide attempts was directly predicted by suicidal ideation. CONCLUSIONS Patients with GD are at risk of presenting suicidal behaviors. The results of this study revealed the importance of comorbid psychopathology in the occurrence of suicidal ideation and the indirect effect of trait impulsivity and emotion dysregulation on suicidality. Thus, suicidal rates in GD could possibly be reduced by specifically targeting these domains during treatment.
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Affiliation(s)
- Núria Mallorquí-Bagué
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | | | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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López-Goñi JJ, Fernández-Montalvo J, Arteaga A, Haro B. Suicidal ideation and attempts in patients who seek treatment for substance use disorder. Psychiatry Res 2018; 269:542-548. [PMID: 30199695 DOI: 10.1016/j.psychres.2018.08.100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 11/24/2022]
Abstract
Patients with substance dependence have a great risk of suicidal ideation and attempts. The study of the specific risk characteristics of patients with substance use disorders who present with suicidal ideation and/or attempts becomes a crucial clinical issue in order to develop prevention strategies. The main goals of this study were to determine the prevalence rate of both suicidal ideation and attempts among patients receiving treatment for substance use disorder and to analyse the differential characteristics between these patients with and without suicidal behaviours. A sample of 334 patients (263 men-71 women) who sought treatment for substance use disorder in a Spanish clinical centre was assessed. In total, 43.7% of the patients presented with lifetime suicidal ideation (8.7% in the last month) and 17.7% with suicide attempts (1.5% in the last month). Patients with suicidal ideation or attempts showed a more severe addiction profile (assessed by the EuropASI), and more psychopathological symptoms (assessed by the SCL-90-R). Moreover the rate of suicidal ideation and attempts was significantly higher in inpatients than in outpatients. According to these results, systematic screening of suicidal risk in patients seeking treatment for substance use disorders is recommended, especially in those with a greater addiction severity.
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Affiliation(s)
- José J López-Goñi
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, 31006 Pamplona, Spain.
| | | | - Alfonso Arteaga
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, 31006 Pamplona, Spain
| | - Begoña Haro
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, 31006 Pamplona, Spain
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Which Psychopathological Syndromes Could Be Associated with the Risk of Suicide among Substance Users? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102279. [PMID: 30336594 PMCID: PMC6209981 DOI: 10.3390/ijerph15102279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/02/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022]
Abstract
Background: Research has shown that suicide is a highly present phenomenon among the drug dependent population. Moreover, individuals with substance use disorder (SUD) present high psychopathological comorbidity. This study aimed to describe which clinical syndromes are linked to the presence of risk of suicide. Methods: The study was based on a consecutive non-probabilistic convenience sample of 196 patients who attended the Public Addiction Center in Girona (Spain). Sociodemographic data, as well as suicide risk and drug related characteristics, were recorded. The risk of suicide was assessed with the Spanish version of "risk of suicide". Complicated grief was assessed with the Spanish version of the Inventory of Complicated Grief. Clinical syndromes were measured with the Spanish version of MCMI-III. Results: The syndromes most frequently associated with the presence of risk of suicide were complicated grief, major depression and thought disorder. Conclusions: Different psychopathological syndromes were identified in relation to risk of suicide among patients with SUD. The present results highlight the importance of accurately diagnosing those individuals.
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