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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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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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McCool MW, Mochrie KD, Lothes JE, Guendner E, St. John J, Noel NE. Drug use and suicidal ideation in the daily lives of individuals in a dialectical behavior therapy program. J Clin Psychol 2023; 79:2556-2565. [PMID: 37462923 PMCID: PMC10592253 DOI: 10.1002/jclp.23564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES Substance use disorders and borderline personality disorders (BPD) often co-occur and may be concurrently treated by Dialectical Behavior Therapy (DBT). However, there is limited information on how drug use and suicidal ideation may interact in the daily lives of individuals receiving DBT treatment. METHODS This study examined the DBT diary cards of 47 individuals in a community mental health center's partial hospital and intensive outpatient program. Multilevel modeling techniques were used to examine the moderating effects of BPD symptom severity on the relationship between same day, 1-, 2-, and 3-day lagged drug use and suicidal ideation. RESULTS Results indicated a significant relationship between same-day, 1-day lagged, 2-day lagged drug use and suicidal ideation. BPD was a moderator for the relationship between 1-day lagged drug use and suicidal ideation. CONCLUSION Limitations of the study include the measure for BPD symptom severity was only collected pretreatment and the results are likely limited to the effects of cannabis use on suicidal ideation. Clinicians may need to consider the prolonged effects of drug use on suicidal ideation when conducting chain analyses on suicidal behaviors.
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Affiliation(s)
- Matison W. McCool
- The Center on Alcohol, Substance Use, And Addictions, The University of New Mexico
| | | | - John E. Lothes
- University of North Carolina Wilmington
- Delta Behavioral Health
| | - Eric Guendner
- University of North Carolina Wilmington
- Delta Behavioral Health
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Hakami MC, Poursharifi H, Dolatshahee B, Seddigh SH. Designing and determining the effectiveness of a suicide intervention package for psychologists working in the primary health care system. J Family Med Prim Care 2023; 12:917-924. [PMID: 37448923 PMCID: PMC10336939 DOI: 10.4103/jfmpc.jfmpc_1187_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 07/18/2023] Open
Abstract
Aims Suicide is a major public health problem around the world. The present study aimed to design and determine the effectiveness of a suicide intervention package for psychologists working in the primary health care system in Hormozgan Province. Materials and Methods This study was conducted in two phases: qualitative and quantitative phases. In the qualitative phase, it was a thematic analysis type, and in the quantitative phase, it was quasi-experimental type with pretest-posttest in two groups of intervention and comparison. To standardize the suicide intervention package, Delphi method was used, and for quantitative content validity, content validity index (CVI) and content validity ratio (CVR) were used. In the quantitative phase of the study, the statistical population of the study included 270 people who had suicidal ideations and had no history of suicide attempt. Among them, 135 people were included in the intervention group and 135 people were included in the comparison group using a convenience sampling method. They were selected among those referred to eight comprehensive rural and urban health service centers in eight cities of Hormozgan Province. The results were analyzed by MANCOVA statistical test. Results CVR was more than 0.75 and CVI was more than 0.87. In the quantitative phase, the results showed a significant difference between the means before and after the intervention for the variables of psychological distress, suicidal ideation, and hopelessness (P < 0.01). Conclusion It seems that psychological suicide preventive interventions in the primary health care system are effective in reducing psychological distress,suicidal thoughts and hopelessness.
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Affiliation(s)
- Mousa Chakeri Hakami
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences. Tehran, Iran
| | - Hamid Poursharifi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Koodakyar Street, Daneshjoo Blvd, Evin, Tehran, Iran
| | - Behrouz Dolatshahee
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences Tehran, Iran
| | - Seyed Hamzeh Seddigh
- Department of Psychiatry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Andersson HW, Mosti MP, Nordfjaern T. Inpatients in substance use treatment with co-occurring psychiatric disorders: a prospective cohort study of characteristics and relapse predictors. BMC Psychiatry 2023; 23:152. [PMID: 36894934 PMCID: PMC9999667 DOI: 10.1186/s12888-023-04632-z] [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: 12/06/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The characteristics of substance use disorder (SUD) inpatients with co-occurring psychiatric disorders (COD) have been scantly described in the extant literature. This study investigated psychological, demographic and substance use characteristics in these patients, along with predictors of relapse 3 months post-treatment. METHODS Prospective data from a cohort of 611 inpatients were analyzed for demographics, motivation, mental distress, SUD diagnosis, psychiatric diagnoses (ICD-10) and relapse rate at 3 months post-treatment (retention rate = 70%). RESULTS Compared to patients without COD (n = 322), those with COD (n = 289) were younger, had higher mental distress, lower education and higher likelihood of no permanent residence. The relapse rate was also higher in patients with COD (39.8%) relative to patients without COD (26.4%) (OR = 1.85, 95% CI: 1.23-2.78). The relapse rate was particularly high for patients with COD who were diagnosed with cannabis use disorder (53.3%). Multivariate analysis revealed that among patients with COD, relapse was more likely for individuals with a cannabis use disorder (OR = 2.31, 95% CI: 1.34-4.00), and less likely for older ages (OR = 0.97, 95% CI: 0.94-1.00), females (OR = 0.56, 95% CI: 0.33-0.98) and for those with higher intrinsic motivation (OR = 0.58, 95% CI: 0.42-0.81). CONCLUSION This study showed that among SUD inpatients, those with COD had relatively persistent high levels of mental distress and an increased risk of relapse. Enhanced measures aimed at COD patients' mental health problems during the inpatient stay, along with close and personalized follow-up after discharge from residential SUD treatment may reduce the probability of relapse in this group.
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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 Nordfjaern
- 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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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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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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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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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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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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Gomes JDA, de Souza DM, Oliveira KD, Gallassi AD. Psychoactive substances use before suicide: detailed analysis of all cases that occurred in the Brazilian Federal District in a 10-years period. BMC Psychiatry 2022; 22:467. [PMID: 35836155 PMCID: PMC9284851 DOI: 10.1186/s12888-022-04082-z] [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] [Received: 09/15/2021] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychoactive substances (PASs) are an important risk factor for suicide. This study investigated the sociodemographic characteristics, data related to the suicidal behavior, the methods employed, the circumstances of the events, and the use of PASs before dying in all suicides that occurred between 2005-2014 in the Brazilian Federal District, comparing cases with positive and negative detection for PASs in the post-mortem analysis to identify groups at greatest risk. METHODS A population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepine). RESULTS The results showed that the increase in the suicide rate was 10 × greater than the population growth, and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, be male, have tried before, and change their behavior days before death; they choose to hang as the method and are influenced by alcohol. CONCLUSION Identifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use and those who have/do not have mental disorders and what methods are employed could be employed as a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk.
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Affiliation(s)
| | - Diego Mendes de Souza
- Forensic Institute, Civil Police of the Brazilian Federal District (PCDF), Brasilia, DF Brazil
| | - Karina Diniz Oliveira
- grid.411087.b0000 0001 0723 2494Division of Psychiatry, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil
| | - Andrea Donatti Gallassi
- Postgraduate Program of Sciences and Health Technology, Faculty of Ceilândia (FCE), University of Brasilia (UnB), Centro Metropolitano 1, Conjunto A-Ceilândia Sul, Brasília, DF, ZIP 72220-900, Brazil. .,Center of Drugs and Associated Vulnerabilities, Faculty of Ceilândia (FCE), University of Brasilia (UnB), Brasilia, DF, Brazil.
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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: 3] [Impact Index Per Article: 1.0] [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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Kelly LM, Rash CJ, Alessi SM, Zajac K. Correlates and predictors of suicidal ideation and substance use among adults seeking substance use treatment with varying levels of suicidality. J Subst Abuse Treat 2020; 119:108145. [PMID: 33138928 PMCID: PMC7609978 DOI: 10.1016/j.jsat.2020.108145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 09/18/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Lourah M Kelly
- University of Connecticut School of Medicine, Farmington, CT 06030, United States of America
| | - Carla J Rash
- University of Connecticut School of Medicine, Farmington, CT 06030, United States of America
| | - Sheila M Alessi
- University of Connecticut School of Medicine, Farmington, CT 06030, United States of America
| | - Kristyn Zajac
- University of Connecticut School of Medicine, Farmington, CT 06030, United States of America.
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Gareeva AE, Badretdinov UG, Akhmetova EA, Kinyasheva KO, Nasibullin TR, Samigullina LI, Timerbulatov IF, Timerbulatova MF, Asadullin AR. [The role of genetic factors in the development of suicidal behavior in individuals with dependence on synthetic cathinones]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:69-77. [PMID: 33244961 DOI: 10.17116/jnevro202012010169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To identify polymorphisms in the genes of dopaminergic and serotonergic systems associated with the risk of suicidal behavior in individuals with dependence on synthetic cathinones. MATERIAL AND METHODS One hundred and eighty-two men with the diagnosis of Substance dependence (ICD-10 F15) tested positive for metabolites of synthetic cathinones (a-PVP, MDPV) in the urine were studied. Genotyping was performed for rs1800497 DRD2, rs4646984 DRD4, VNTR 40 b.p. SLC6A3, rs27072 SLC6A3, rs6313 HTR2A and rs6296 HTR1B using PCR and RFLP technique. RESULTS AND CONCLUSION It was found that the genes of the serotonergic system HTR2A and HTR1B are predictors of the development of some endophenotypes of suicidal behavior in individuals with dependence on synthetic cathinones.
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Affiliation(s)
- A E Gareeva
- Bashkir State Medical University, Ufa, Russia.,Institute of Biochemistry and Genetics, the Russian Academy of Sciences, Ufa, Russia
| | | | | | - K O Kinyasheva
- Institute of Biochemistry and Genetics, the Russian Academy of Sciences, Ufa, Russia
| | - T R Nasibullin
- Institute of Biochemistry and Genetics, the Russian Academy of Sciences, Ufa, Russia
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