1
|
Miller P, Vakidis T, Taylor N, Baker T, Stella J, Egerton-Warburton D, Hyder S, Staiger P, Bowe SJ, Shepherd J, Zordan R, Walby A, Jones ML, Caldicott D, Barker D, Hall M, Doran CM, Ezard N, Preisz P, Havard A, Shakeshaft A, Akhlaghi H, Kloot K, Lowry N, Bumpstead S. Most common principal diagnoses assigned to Australian emergency department presentations involving alcohol use: a multi-centre study. Aust N Z J Public Health 2022; 46:903-909. [PMID: 36121276 DOI: 10.1111/1753-6405.13303] [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: 12/01/2021] [Revised: 04/01/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Alcohol is the most widely consumed psychoactive substance in Australia and the consequences of alcohol consumption have enormous personal and social impacts. This study aimed to describe the principal diagnoses of emergency department (ED) presentations involving alcohol use in the previous 12 hours at eight hospitals in Victoria and the Australian Capital Territory, Australia. METHODS Twelve months' data (1 July 2018 - 30 June 2019) were collected from eight EDs, including demographics, ICD-10 codes, hospital location and self-reported drinking in the preceding 12 hours. The ten most common ICD-10 discharge codes were analysed based on age, sex and hospital geographic area. RESULTS ICD codes pertaining to mental and behavioural disorders due to alcohol use accounted for the highest proportion in most EDs. Suicide ideation/attempt was in the five highest ICD codes for all but one hospital. It was the second most common alcohol-related presentation for both males and females. CONCLUSIONS Alcohol plays a major role in a range of presentations, especially in relation to mental health and suicide. IMPLICATIONS FOR PUBLIC HEALTH The collection of alcohol involvement in ED presentations represents a major step forward in informing the community about the burden of alcohol on their health resources.
Collapse
Affiliation(s)
- Peter Miller
- School of Psychology, Deakin University, Victoria
| | - Thea Vakidis
- School of Psychology, Deakin University, Victoria
| | - Nicholas Taylor
- School of Psychology, Deakin University, Victoria.,National Drug Research Institute, Curtin University, Victoria
| | - Tim Baker
- Centre for Rural Emergency Medicine, Faculty of Health, Deakin University, Victoria.,South West Healthcare, Victoria
| | | | | | | | | | | | - Jonathan Shepherd
- Crime and Security Research Institute, Cardiff University, Wales, UK
| | - Rachel Zordan
- St Vincent's Hospital Melbourne, Victoria.,Melbourne Medical School, University of Melbourne, Victoria
| | | | - Martyn Lloyd Jones
- VMO Department of Addiction Medicine, St Vincent's Hospital Melbourne, Victoria.,Alfred Addiction and Mental Health, the Alfred Hospital, Victoria
| | | | - Daniel Barker
- School of Medicine and Public Health, University of Newcastle, New South Wales
| | | | - Christopher M Doran
- Cluster for Resilience and Well-being, Appleton Institute, Central Queensland University, Queensland
| | - Nadine Ezard
- St Vincent's Hospital Sydney, National Centre for Clinical Research on Emerging Drugs, New South Wales.,National Drug and Alcohol Research Centre, UNSW Sydney, New South Wales
| | - Paul Preisz
- St Vincent's Hospital Darlinghurst, New South Wales.,Faculty of Medicine & Health, UNSW Sydney, New South Wales.,School of Medicine, University Notre Dame, New South Wales
| | - Alys Havard
- National Drug and Alcohol Research Centre, UNSW Sydney, New South Wales.,Centre for Big Data Research in Health, UNSW Sydney, New South Wales
| | | | - Hamed Akhlaghi
- St Vincent's Hospital Melbourne, Victoria.,Melbourne Medical School, University of Melbourne, Victoria
| | - Kate Kloot
- School of Medicine, Deakin University, Victoria
| | | | | |
Collapse
|
2
|
Association Between Patterns of Alcohol Use and Short-Term Risk of Suicide Attempt Among Patients With and Without Reported Suicidal Ideation. J Addict Med 2021; 14:e160-e169. [PMID: 32142058 DOI: 10.1097/adm.0000000000000637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the association between patterns of alcohol use and short-term risk of suicide attempt among patients with and without reported suicidal ideation. METHODS Kaiser Permanente Washington electronic health record data were used to identify mental health visits (1/1/2010-6/30/2015) with documented assessments for unhealthy alcohol use (AUDIT-C) and suicidal ideation (PHQ-9 ninth question). Logistic regression fit using generalized estimating equations were used to conduct visit-level analyses, accounting for correlation between individuals' assessments. Separate models evaluated the association between (1) level of alcohol consumption and (2) frequency of heavy episodic drinking (HED), in combination with suicidal ideation (any vs none), with suicide attempt within 90 days following each visit. Primary models adjusted for age, gender, race/ethnicity and visit year. RESULTS Of 59,705 visits (43,706 unique patients), 372 (0.62%) were followed by a suicide attempt within 90 days. The risk of suicide attempt was significantly higher for patients reporting suicidal ideation across all levels of alcohol consumption compared to patients reporting low-level alcohol use and no suicidal ideation, particularly high-level use (OR 9.77, 95% CI, 6.23-15.34). Similarly, risk of suicide attempt was higher for patients reporting suicidal ideation across all levels of HED relative to those reporting no HED or suicidal ideation, particularly HED monthly or more (OR 6.80, 95% CI 4.77-9.72). Among patients reporting no suicidal ideation, no associations were observed. CONCLUSIONS Findings underscore the potential value of offering alcohol-related care to patient reporting suicidal ideation. Additional strategies are needed to identify suicide risk among those reporting no suicidal ideation.
Collapse
|
3
|
Richards JE, Simon GE, Boggs JM, Beidas R, Yarborough BJH, Coleman KJ, Sterling SA, Beck A, Flores JP, Bruschke C, Grumet JG, Stewart CC, Schoenbaum M, Westphal J, Ahmedani BK. An implementation evaluation of "Zero Suicide" using normalization process theory to support high-quality care for patients at risk of suicide. IMPLEMENTATION RESEARCH AND PRACTICE 2021; 2. [PMID: 34447940 PMCID: PMC8384258 DOI: 10.1177/26334895211011769] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Suicide rates continue to rise across the United States, galvanizing the need for increased suicide prevention and intervention efforts. The Zero Suicide (ZS) model was developed in response to this need and highlights four key clinical functions of high-quality health care for patients at risk of suicide. The goal of this quality improvement study was to understand how six large health care systems operationalized practices to support these functions-identification, engagement, treatment and care transitions. Methods Using a key informant interview guide and data collection template, researchers who were embedded in each health care system cataloged and summarized current and future practices supporting ZS, including, (1) the function addressed; (2) a description of practice intent and mechanism of intervention; (3) the target patient population and service setting; (4) when/how the practice was (or will be) implemented; and (5) whether/how the practice was documented and/or measured. Normalization process theory (NPT), an implementation evaluation framework, was applied to help understand how ZS had been operationalized in routine clinical practices and, specifically, what ZS practices were described by key informants (coherence), the current state of norms/conventions supporting these practices (cognitive participation), how health care teams performed these practices (collective action), and whether/how practices were measured when they occurred (reflexive monitoring). Results The most well-defined and consistently measured ZS practices (current and future) focused on the identification of patients at high risk of suicide. Stakeholders also described numerous engagement and treatment practices, and some practices intended to support care transitions. However, few engagement and transition practices were systematically measured, and few treatment practices were designed specifically for patients at risk of suicide. Conclusions The findings from this study will support large-scale evaluation of the effectiveness of ZS implementation and inform recommendations for implementation of high-quality suicide-related care in health care systems nationwide.
Collapse
Affiliation(s)
- Julie E Richards
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.,Department of Health Services, University of Washington, Seattle, WA, USA
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Jennifer M Boggs
- Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, USA
| | - Rinad Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA
| | | | - Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Arne Beck
- Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, USA
| | - Jean P Flores
- Care Management Institute, Kaiser Permanente, Oakland, CA, USA
| | | | | | | | - Michael Schoenbaum
- Division of Services and Intervention Research, National Institute of Mental Health, Rockville, MD, USA
| | - Joslyn Westphal
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| |
Collapse
|
4
|
Boenisch S, Bramesfeld A, Mergl R, Havers I, Althaus D, Lehfeld H, Niklewski G, Hegerl U. The Role Of Alcohol Use Disorder And Alcohol Consumption In Suicide Attempts-A Secondary Analysis Of 1921 Suicide Attempts. Eur Psychiatry 2020; 25:414-20. [DOI: 10.1016/j.eurpsy.2009.11.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 11/09/2009] [Accepted: 11/09/2009] [Indexed: 10/19/2022] Open
Abstract
AbstractBackgroundIt is not known how characteristics of suicide attempts vary with different forms of alcohol involvement. The aim of this study is to clarify the role of alcohol use disorder and acute alcohol consumption in suicide attempts.MethodsData on 1921 suicide attempts was gathered in a major German city over a 5-year period. Suicide attempts were categorised according to a diagnosis of alcohol use disorder and acute alcohol consumption at the time of the attempt. Group comparisons and multinomial logistic regression were used for statistical analysis.ResultsIn 331 suicide attempts (17%) an alcohol use disorder was diagnosed. Six hundred and twenty-two suicide attempts (32%) were committed with acute alcohol consumption. Suicide attempts by individuals with alcohol use disorder were more often committed by men, older individuals and as a recurrent attempt, independently of alcohol consumption at the time of the attempt. When alcohol was consumed in suicide attempts by individuals with alcohol use disorder, low-risk methods were used most often.ConclusionsIndividuals with a diagnosis of alcohol use disorder are a high-risk group for multiple suicide attempts and should be a target group for suicide prevention. Screening for suicidality should be a regular part of the clinical assessment in individuals with alcohol use disorder.
Collapse
|
5
|
Salles J, Tiret B, Gallini A, Gandia P, Arbus C, Mathur A, Bougon E. Suicide Attempts: How Does the Acute Use of Alcohol Affect Suicide Intent? Suicide Life Threat Behav 2020; 50:315-328. [PMID: 31532854 DOI: 10.1111/sltb.12586] [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] [Received: 08/22/2018] [Accepted: 06/17/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Very few studies have specifically addressed the role of the acute use of alcohol (AUA) in suicide attempts. OBJECTIVE Our study compared the suicide intent scores of self-poisoning patients with and without AUA in order to examine the role of alcohol in attempted suicides. METHODS We recruited 516 patients admitted to the emergency department for self-poisoning. We screened blood alcohol concentrations (BACs) to determine whether these were positive or negative in the two groups. We collected data about covariates such as psychiatric disorders and sociodemographic and suicide characteristics. We then compared suicide intent between the groups, adjusted according to the covariates. RESULTS The patients with AUA had lower scores for suicide intent, but this factor only reduced the self-reporting score, with the scores for objective circumstances and risk similar between the groups. There was a correlation between BACs and self-reported suicide intentionality, but this was not significant. CONCLUSION Acute use of alcohol patients presented with lower suicide intent, as particularly explained by the self-report scores, but there were no differences between the groups in terms of risk and/or the objective circumstances. The role of alcohol in the self-reporting of suicide attempts must be addressed in future studies.
Collapse
Affiliation(s)
- Juliette Salles
- Université de Toulouse III, Toulouse, France.,Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France.,INSERM U1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France
| | - Bernard Tiret
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Adeline Gallini
- Université de Toulouse III, Toulouse, France.,Département d'Épidémiologie et de Santé Publique, Institut Fédératif de Biologie, CHU Toulouse, Toulouse, France
| | - Peggy Gandia
- Université de Toulouse III, Toulouse, France.,Service de Pharmacocinétique et Toxicologie, Institut Fédératif de Biologie, CHU Toulouse, Toulouse, France
| | - Christophe Arbus
- Université de Toulouse III, Toulouse, France.,Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Anjali Mathur
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Emmanuelle Bougon
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| |
Collapse
|
6
|
Short-term risk of suicide attempt associated with patterns of patient-reported alcohol use determined by routine AUDIT-C among adults receiving mental healthcare. Gen Hosp Psychiatry 2020; 62:79-86. [PMID: 31874300 PMCID: PMC7047881 DOI: 10.1016/j.genhosppsych.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the association between alcohol use routinely reported during outpatient mental healthcare visits and short-term risk of subsequent suicide attempt. METHODS Using a longitudinal retrospective-cohort design, electronic health records identified adult outpatient visits to a mental health provider (1/1/2010-6/30/2015) at Kaiser Permanente Washington with a documented Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]. Suicide attempts within 90 days of AUDIT-C documentation were defined using death certificate cause-of-death and diagnosis codes (non-lethal). Visit-level analyses used generalized estimating equations to account for correlation between multiple AUDIT-Cs for individuals. Separate models evaluated the association between (1) level of consumption and (2) frequency of heavy drinking episodes and suicide attempts, adjusted for visit year, demographics, depressive symptom, and suicidal ideation. RESULTS Of 59,382 patient visits, 0.62% (N = 371) were followed by a suicide attempt within 90 days. Patients reporting high-level alcohol use were 1.77 times (95% CI, 1.22-2.57) more likely to attempt suicide than those reporting low-level use. Patients reporting daily or almost daily heavy drinking episodes were 2.33 times (95% CI, 1.38-3.93) more likely to attempt suicide than those reporting none. CONCLUSIONS AND RELEVANCE The AUDIT-C is a valuable tool for assessing patterns of patient-reported alcohol use associated with subsequent suicide attempt.
Collapse
|
7
|
Lee J, Chang SJ, Kim H, Kim MH, Ahn JS, Park KC, Moon JS, Min S. Prolonged Risk of Suicide Reattempts in Patients with Alcohol Use Disorder and Acute Alcohol Use: A Register-Based Follow-Up Study (2010-2015). Psychiatry Investig 2019; 16:145-153. [PMID: 30808121 PMCID: PMC6393750 DOI: 10.30773/pi.2018.11.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 11/22/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE This study aimed to clarify the role of acute alcohol use and alcohol use disorder in individuals exhibiting suicidal behaviors, including repetition of suicide attempt. METHODS Data pertaining to 691 suicide attempters who had visited an emergency center and had been followed-up from 2010 to 2015 were gathered. Participants were categorized into following three groups according to alcohol use pattern at the time of the suicide attempt: 1) suicide attempters with neither alcohol use disorder nor acute alcohol consumption (NAU), 2) suicide attempters who had used alcohol during the suicide attempt but did not have alcohol use disorder (AAU), and 3) suicide attempters with alcohol use disorder (AUD). Group comparisons and multivariate Cox proportional models for suicidal behavior were used for statistical analysis. RESULTS AUD have been shown to have lower lethality of suicide attempt but higher risk of suicide reattempts in the future. Furthermore, positive relationships between suicide reattempts and AUD persisted throughout the longer period than other groups. CONCLUSION Suicide attempters with AUD should be considered a high-risk group for suicide reattempts in future, and this group should be followed-up for a longer period with specialized care program.
Collapse
Affiliation(s)
- Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sei Jin Chang
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Joung-Sook Ahn
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Ki-Chang Park
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jin Sil Moon
- Center of Biomedical Data Science (CBDS), Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seongho Min
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| |
Collapse
|
8
|
Comparison of selected clinical and personality variables in alcohol–dependent patients with or without a history of suicide attempts. CURRENT PROBLEMS OF PSYCHIATRY 2018. [DOI: 10.2478/cpp-2018-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Objective: The aim of the study was to determine differences in the range of socio-demographic variables, selected clinical variables, temperament and character traits, coping with stress strategies and the level of aggression in alcohol addicts with or without a history of suicide attempt(s).
Methods: The study involved 90 people addicted to alcohol, treated in inpatient alcohol dependence treatment program. In order to collect data on socio - demographic variables and selected clinical variables, a self-made questionnaire was used. The severity of alcohol dependence was verified using the MAST and SADD scales. Characteristics of temperament and character were examined with the TCI questionnaire. The BPAQ and COPE questionnaires were used to examine the level of aggression and styles of coping with stress.
Results:Out of 90 subjects with alcohol dependence syndrom, 20% had attempted suicide in the past. The respondents with a history of suicide attempts were statistically significantly younger, were characterized by a younger age of alcohol drinking initiation and the initiation of regular alcohol drinking, and a greater severity of alcohol dependence in the MAST and SADD scales. A significantly larger percentage of respondents who had attempted suicide inflicted self-injury in the past, used other psychoactive substances as well as hypnotics and sedatives. The subjects with a suicide attempt in the interview obtained statistically significantly higher scores in terms of the level of aggression, harm avoidance and self-directedness, and more often used the style of coping with stress based on avoidance and accepting the situation.
Conclusions: The obtained results correspond with data available in the literature and may provide a foundation for theoretical models explaining the phenomenon of suicidal behavior in alcohol addicts as well as for suicide prevention programs in this group of patients.
Collapse
|
9
|
Kim E, Jeong KY, Lee JS, Choi HS. Predictive Value of Psychological Scales for Hospitalization of Elderly Suicide Attempters. Ann Geriatr Med Res 2017. [DOI: 10.4235/agmr.2017.21.4.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Eundo Kim
- Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Ki Young Jeong
- Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jong Seok Lee
- Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Han Sung Choi
- Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| |
Collapse
|
10
|
Pelissier F, de Haro L, Rolland B, Franchitto N. Severity of Baclofen Self-Poisoning Linked to Psychiatric Co-morbidity in Alcohol-Dependent Patients: Better Measurement of Risk and Benefit. Basic Clin Pharmacol Toxicol 2017; 121:217-219. [PMID: 28693052 DOI: 10.1111/bcpt.12832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Fanny Pelissier
- Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France
| | - Luc de Haro
- Poison Control Center, Clinical Pharmacology Department, Sainte Marguerite Hospital, Marseille, France
| | - Benjamin Rolland
- Department of Psychiatry and Addictology, Lille University Hospital, Lille, France
| | - Nicolas Franchitto
- Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France.,Department of Addiction Medicine, Toulouse-Purpan University Hospital, Toulouse, France
| |
Collapse
|
11
|
Boels D, Victorri-Vigneau C, Grall-Bronnec M, Touré A, Garnier A, Turcant A, Le Roux G. Baclofen and Alcohol-Dependent Patients: A Real Risk of Severe Self-Poisoning. Basic Clin Pharmacol Toxicol 2017; 121:353-359. [DOI: 10.1111/bcpt.12779] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- David Boels
- Poison Control Center; Angers University Hospital; Angers France
- UMR 1246 SPHERE; Methods for Patients-Centered Outcomes and Health Research; Nantes University Hospital; Nantes France
| | - Caroline Victorri-Vigneau
- UMR 1246 SPHERE; Methods for Patients-Centered Outcomes and Health Research; Nantes University Hospital; Nantes France
- Pharmacology Department - Addictovigilance; Nantes University Hospital; Nantes France
| | - Marie Grall-Bronnec
- UMR 1246 SPHERE; Methods for Patients-Centered Outcomes and Health Research; Nantes University Hospital; Nantes France
- Addictology and Psychiatry Department; Nantes University Hospital; Nantes France
| | - Ali Touré
- Poison Control Center; Angers University Hospital; Angers France
| | - Anais Garnier
- Poison Control Center; Angers University Hospital; Angers France
| | - Alain Turcant
- Pharmacology Department - Laboratory; Angers University Hospital; Angers France
| | - Gaël Le Roux
- Poison Control Center; Angers University Hospital; Angers France
| |
Collapse
|
12
|
Pelissier F, de Haro L, Cardona F, Picot C, Puskarczyk E, Sapori JM, Tournoud C, Franchitto N. Self-poisoning with baclofen in alcohol-dependent patients: national reports to French Poison Control Centers, 2008–2013. Clin Toxicol (Phila) 2017; 55:275-284. [DOI: 10.1080/15563650.2017.1284330] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Fanny Pelissier
- Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France
| | - Luc de Haro
- Poison Control Center, Clinical Pharmacology Department, Sainte Marguerite Hospital, Marseille, France
- Groupe de Travail Toxicovigilance des Médicaments, ANSM, Saint Denis, France
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
| | - Florence Cardona
- Groupe de Travail Toxicovigilance des Médicaments, ANSM, Saint Denis, France
- French National Agency for Medicines and Health Products Safety (ANSM), Saint Denis, France
| | - Cyndie Picot
- Groupe de Travail Toxicovigilance des Médicaments, ANSM, Saint Denis, France
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
- French National Agency for Medicines and Health Products Safety (ANSM), Saint Denis, France
| | - Emmanuel Puskarczyk
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
- Poison Information and Toxicovigilance Center, Nancy University Medical Center, Nancy, France
| | - Jean-Marc Sapori
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
- Toxicovigilance and Poison Control Center, Hospices Civils de Lyon, Lyon, France
| | - Christine Tournoud
- Groupe de Travail Toxicovigilance des Médicaments, ANSM, Saint Denis, France
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
- Poison Information and Toxicovigilance Center, Hôpital Civil, Strasbourg, France
| | - Nicolas Franchitto
- Poison Control Center, Toulouse-Purpan University Hospital, Toulouse, France
- Groupe de Travail Toxicovigilance des Médicaments, ANSM, Saint Denis, France
- Comité de Coordination de Toxicovigilance, Institut de Veille Sanitaire (InVS), Saint Maurice, France
- Department of Addiction Medicine, Toulouse-Purpan University Hospital, Toulouse, France
| |
Collapse
|
13
|
Bagge CL, Conner KR, Reed L, Dawkins M, Murray K. Alcohol use to facilitate a suicide attempt: an event-based examination. J Stud Alcohol Drugs 2016; 76:474-81. [PMID: 25978835 DOI: 10.15288/jsad.2015.76.474] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The current study is based on the hypothesis that alcohol-involved suicide attempts are characterized by lower premeditation and intent, but only when the use of alcohol is not motivated by the desire to facilitate the attempt. Test of this idea was conducted by comparing proximal suicide premeditation and intent of suicide attempts among three groups: individuals who (a) drank to facilitate the attempt (e.g., to "numb fears" about attempting), (b) drank for nonfacilitative motives, and (c) did not use alcohol before the attempt. METHOD Participants included 324 (62% female) recent suicide attempters presenting to a Level 1 trauma hospital. The Timeline Followback Interview for Suicide Attempts and a novel Suicide Facilitative Drinking Motives Scale were used to assess facilitative motives for drinking and characteristics of the attempt. RESULTS One third of participants drank before the attempt, and most (73%) who used alcohol did not do so to facilitate the attempt. As hypothesized, attempts carried out by this group had shorter proximal suicide premeditation and lower suicide intent compared with the other study groups; in contrast, individuals who drank to facilitate the attempt were similar to non-alcohol users on these indices. CONCLUSIONS Alcohol-involved suicide attempts are heterogeneous. Motives for drinking are a key source of heterogeneity insofar as fundamental characteristics of attempts (proximal premeditation, intent) differ as a function of drinking motivation. Clinical implications include that individuals making suicide attempts with facilitative motives for drinking cannot be assumed to be at lowered risk upon a drop in blood alcohol level.
Collapse
Affiliation(s)
- Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kenneth R Conner
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York.,VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York
| | - Louren Reed
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Milton Dawkins
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kevin Murray
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
14
|
Carter J, Sharon E, Stern TA. The management of alcohol use disorders: the impact of pharmacologic, affective, behavioral, and cognitive approaches. Prim Care Companion CNS Disord 2015; 16:14f01683. [PMID: 25664205 DOI: 10.4088/pcc.14f01683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 06/25/2014] [Indexed: 12/11/2022] Open
|
15
|
Masferrer L, Garre-Olmo J, Caparros B. Risk of suicide: its occurrence and related variables among bereaved substance users. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2014.998733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
16
|
Dissociation et passage à l’acte violent : une revue de littérature. EVOLUTION PSYCHIATRIQUE 2015. [DOI: 10.1016/j.evopsy.2014.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
17
|
Franchitto N, Pelissier F, Lauque D, Simon N, Lançon C. Self-Intoxication with Baclofen in Alcohol-Dependent Patients with Co-existing Psychiatric Illness: An Emergency Department Case Series. Alcohol Alcohol 2013; 49:79-83. [DOI: 10.1093/alcalc/agt169] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
18
|
Lejoyeux M, Nivoli F, Basquin A, Petit A, Chalvin F, Embouazza H. An Investigation of Factors Increasing the Risk of Aggressive Behavior among Schizophrenic Inpatients. Front Psychiatry 2013; 4:97. [PMID: 24027539 PMCID: PMC3759799 DOI: 10.3389/fpsyt.2013.00097] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 08/19/2013] [Indexed: 01/24/2023] Open
Abstract
AIM OF THE STUDY This study tried to identify risk factors of aggressive behavior in a population of schizophrenic inpatients. We tested the association between aggressive behavior and socio-demographic characteristics, addictive disorders, history of suicide attempt, and sexual violence, impulsivity, and sensation seeking. METHODS All consecutive schizophrenic inpatients (100) were assessed during 6 months. Aggressive behavior was quantified with a standardized scale, the Overt Aggression Scale (OAS). We studied socio-demographic characteristics and the history of suicide attempt and sexual violence with a specific standardized questionnaire. Addictive disorders were identified with the Fagerström and CAGE questionnaires and with the DSM-IV-R diagnostic criteria for nicotine, alcohol, cannabis opiates, and cocaine abuse and dependence disorders. Lastly, we studied sensation seeking with the Zuckerman scale and impulsivity with the Barratt scale. RESULTS Linear regression identified four factors associated with aggressive behavior: male gender (odd ratio = 12.8), history of sexual violence (odd ratio = 3.6), Fagerström score (odd ratio = 1.3), number of cigarettes smoked each day (odd ratio = 1.16). Patients with nicotine use or dependence had significantly higher levels of OAS scores. This difference was not observed between patients with or without alcohol dependence. OAS scores were correlated to the number of cigarettes smoked each day and to Fagerström scores. Patients with a higher level of sensation seeking and impulsivity also had higher OAS scores. CONCLUSION A typical schizophrenic patient at risk of showing aggressive behavior is a man, who smokes and presents a history of sexual violence.
Collapse
Affiliation(s)
- Michel Lejoyeux
- Department of Psychiatry and Addictive Medicine, Bichat-Claude Bernard Hospital, AP-HP , Paris , France ; Department of Psychiatry, Maison Blanche Hospital , Paris , France
| | | | | | | | | | | |
Collapse
|
19
|
Ronquillo L, Minassian A, Vilke GM, Wilson MP. Literature-based recommendations for suicide assessment in the emergency department: a review. J Emerg Med 2012; 43:836-42. [PMID: 23040403 DOI: 10.1016/j.jemermed.2012.08.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 08/15/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicidal ideation and attempted suicide are important presenting complaints in the Emergency Department (ED). The Joint Commission established a National Patient Safety Goal that requires screening for suicidal ideation to identify patients at risk for suicide. OBJECTIVES Given the emphasis on screening for suicidal ideation in the general hospital and ED, it is important for Emergency Physicians to be able to understand and perform suicide risk assessment. METHODS A review of literature was conducted using PubMed to determine important elements of suicide assessment in adults, ages 18 years and over, in the ED. Four typical ED cases are presented and the assessment of suicide risk in each case is discussed. RESULTS The goal of an ED evaluation is to appropriately determine which patients are at lowest suicide risk, and which patients are at higher or indeterminate risk such that psychiatry consultation is warranted while the patient is in the ED. Emergency clinicians should estimate this risk by taking into account baseline risk factors, such as previous suicide attempts, as well as acute risk factors, such as the presence of a suicide plan. CONCLUSION Although a brief screening of suicide risk in the ED does not have the sensitivity to accurately determine which patients are at highest risk of suicide after leaving the ED, patients at lowest risk may be identified. In these low-risk patients, psychiatric holds and real-time psychiatric consultation while in the ED may not be needed, facilitating more expeditious dispositions from the ED.
Collapse
Affiliation(s)
- Linda Ronquillo
- Alliant International University, California School of Professional Psychology, San Diego, California 92122, USA
| | | | | | | |
Collapse
|
20
|
Klimkiewicz A, Ilgen MA, Bohnert ASB, Jakubczyk A, Wojnar M, Brower KJ. Suicide attempts during heavy drinking episodes among individuals entering alcohol treatment in Warsaw, Poland. Alcohol Alcohol 2012; 47:571-6. [PMID: 22691386 DOI: 10.1093/alcalc/ags069] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Acute alcohol intoxication itself may act as a trigger for suicidal thoughts and attempts among individuals at risk and may influence the potential lethality of the suicide attempt. This study in alcohol-dependent patients compared the correlates of suicide attempts during a heavy drinking episode with those of suicide attempts during relative sobriety. METHODS In two outpatient and two residential alcohol treatment programs in Warsaw, Poland, 113 patients who reported a suicide attempt during their lifetime were interviewed. The analyses focused on the patients' most serious suicide attempts and on whether these occurred during a heavy drinking episode. RESULTS Over two-thirds of the patients reported that their most serious suicide attempt occurred during a period of heavy drinking. A multivariable logistic model indicated that the following factors significantly distinguished those patients whose most serious suicide attempt occurred during a heavy drinking episode: male gender, younger current age, greater severity of alcohol dependence and the attempt being unplanned. CONCLUSION Among the patients in treatment for alcohol dependence who made a suicide attempt, the most serious attempt was likely to have been unplanned and committed by men when it occurred during a heavy drinking episode.
Collapse
Affiliation(s)
- Anna Klimkiewicz
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | | | | | | | | | | |
Collapse
|
21
|
Lejoyeux M, Gastal D, Bergeret A, Casalino E, Lequen V, Guillermet S. Alcohol use disorders among patients examined in emergency departments after a suicide attempt. Eur Addict Res 2012; 18:26-33. [PMID: 22156705 DOI: 10.1159/000332233] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 08/27/2011] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY To assess the prevalence of alcohol use disorders (AUD) in a population of patients examined following attempted suicide and compare suicide attempts with and without AUD. METHODS 180 patients examined in an emergency department after a suicide attempt were compared with 180 controls paired for sex and age. All patients answered the CAGE and the Fagerström questionnaire. The DSM-IV-R criteria for alcohol, nicotine and cannabis abuse and dependence, as well as for borderline and antisocial personality, were checked. RESULTS The prevalence of AUD was 43% among suicide attempters. Suicide attempters with AUD were more often men (52 vs. 30%), living alone (64 vs. 31%) and older (35.9 vs. 32.3 years). They were more often dependent on nicotine (87 vs. 43%) and smoked more cannabis joints (1.4 vs. 0.5). They had taken alcohol before committing suicide more often (61 vs. 23%) and had more previous suicide attempts (2.5 vs. 0.9). Additionally, suicide attempters had higher scores of sensation seeking and presented more often with an antisocial or borderline personality. CONCLUSION 43% of the patients examined after a suicide attempt presented with AUD. Emergency units may provide an opportunity to identify their dependence disorder and offer information and treatment.
Collapse
Affiliation(s)
- Michel Lejoyeux
- Department of Psychiatry and Addictive Medicine, Bichat-Claude Bernard Hospital, AP-HP, Paris, France.
| | | | | | | | | | | |
Collapse
|
22
|
Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V, van Ommeren M, Yasamy MT, Ayuso-Mateos JL, Birbeck GL, Drummond C, Freeman M, Giannakopoulos P, Levav I, Obot IS, Omigbodun O, Patel V, Phillips M, Prince M, Rahimi-Movaghar A, Rahman A, Sander JW, Saunders JB, Servili C, Rangaswamy T, Unützer J, Ventevogel P, Vijayakumar L, Thornicroft G, Saxena S. Evidence-based guidelines for mental, neurological, and substance use disorders in low- and middle-income countries: summary of WHO recommendations. PLoS Med 2011; 8:e1001122. [PMID: 22110406 PMCID: PMC3217030 DOI: 10.1371/journal.pmed.1001122] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Shekhar Saxena and colleagues summarize the recent WHO Mental Health Gap Action Programme (mhGAP) intervention guide that provides evidence-based management recommendations for mental, neurological, and substance use (MNS) disorders.
Collapse
Affiliation(s)
- Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health, Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
| | - Nicolas Clark
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | - Alexandra Fleischmann
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | - Mark van Ommeren
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | - M. Taghi Yasamy
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| | | | - Gretchen L. Birbeck
- International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan, United States of America; Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Colin Drummond
- Department of Addiction, National Addiction Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Melvyn Freeman
- Cluster Manager, Non-communicable Diseases, National Department of Health, Pretoria, South Africa
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University Hospitals and Faculty of Medicine of the University of Geneva, Geneva; Department of Psychiatry, Division of Old Age Psychiatry, Hospices-CHUV, Lausanne, Switzerland
| | - Itzhak Levav
- Mental Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Olayinka Omigbodun
- College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria
| | - Vikram Patel
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, United Kingdom; Sangath, Goa, India
| | - Michael Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Global Health, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Martin Prince
- King's College London, Institute of Psychiatry, Health Service and Population Research Department, London, United Kingdom
| | - Afarin Rahimi-Movaghar
- Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran
| | - Atif Rahman
- University of Liverpool, Institute of Psychology, Health & Society; Child Mental Health Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Josemir W. Sander
- UCL Institute of Neurology, Queen Square, London, United Kingdom, SEIN – Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | | | - Chiara Servili
- Child and Adolescent Health and Development, WHO Eritrea, Asmara, Eritrea
| | | | - Jürgen Unützer
- Department of Psychiatry and Behavioural Sciences, University of Washington Medical Center; UW AIMS Center; IMPACT Implementation Program, Seattle, Washington, United States of America
| | | | | | - Graham Thornicroft
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland
| |
Collapse
|
23
|
Lima DD, Azevedo RCSD, Gaspar KC, Silva VFD, Mauro MLF, Botega NJ. Tentativa de suicídio entre pacientes com uso nocivo de bebidas alcoólicas internados em hospital geral. JORNAL BRASILEIRO DE PSIQUIATRIA 2010. [DOI: 10.1590/s0047-20852010000300001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Detectar fatores associados a histórico de tentativa de suicídio (TS) em pacientes internados em hospital geral que fazem uso nocivo de bebidas alcoólicas. MÉTODO: 4.352 pacientes admitidos consecutivamente foram avaliados utilizando-se um rastreamento do qual constavam as escalas AUDIT (Alcohol Use Disorder Identification Test) e HAD (Escala Hospitalar de Ansiedade e Depressão). Fixando-se histórico de tentativa de suicídio ao longo da vida como variável dependente, foram realizados testes do qui-quadrado e regressão logística múltipla. RESULTADOS: Uso nocivo de álcool (AUDIT > 8) foi detectado em 423 pacientes. Dentre eles, 60 (14,2%) apresentavam sintomas de depressão (HAD > 8) e 34 (8%) tinham histórico de TS. Este se associou a ser adulto jovem [razão de chance (RC) = 3,4], depressão (RC = 6,6), uso pregresso de psicofármaco (RC = 7) e ter SIDA (RC = 24). CONCLUSÃO: Os resultados fortalecem a necessidade de detectar e tratar adequadamente condições que, combinadas, aumentam consideravelmente o risco de suicídio.
Collapse
|
24
|
Getachew B, Hauser SR, Taylor RE, Tizabi Y. Desipramine blocks alcohol-induced anxiety- and depressive-like behaviors in two rat strains. Pharmacol Biochem Behav 2008; 91:97-103. [PMID: 18640149 DOI: 10.1016/j.pbb.2008.06.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 06/18/2008] [Accepted: 06/24/2008] [Indexed: 10/21/2022]
Abstract
Epidemiological studies indicate significant co-morbid expression of alcoholism, anxiety, and depression. These symptoms are often under-diagnosed and under-treated and can worsen prognostic and treatment outcome for alcoholism. Nonetheless, a causal relationship between alcoholism and these conditions is yet to be established. In this study we sought to determine the effects of daily alcohol administration on the indices of anxiety and depression in two rat strains, one of which exhibits inherent depressive-like characteristics. Moreover, it was of relevance to examine the effects of a clinically useful antidepressant on alcohol-induced behavioral changes. Wistar-Kyoto (WKY) rats derived from Wistar stock show low levels of locomotor activity in an open field and high levels of immobility in the forced swim test (FST) which is considered a measure of their helplessness and hence are considered a putative animal model of depression. Adult female WKY and Wistar rats were exposed for 3 hrs daily to 95% ethanol vapor to achieve a mean blood alcohol level (BAL) of approximately 150 mg/dL. Controls were exposed to air in similar inhalation chambers. Sixteen to 18 hrs following 7 or 14 days of exposure to alcohol, locomotor activity (LCA) in open field, duration of time spent in the open arm of the elevated plus-maze (EPM), reflective of anxiety-like behavior and immobility in FST were evaluated. Alcohol exposure for 7 or 14 days reduced LCA only in Wistar rats but enhanced FST immobility in both strains at both time points. Only 14 day alcohol exposure reduced EPM open arm time in both WKY and Wistar rats. Daily treatment with desipramine (8 mg/kg) blocked all the changes induced by alcohol in both strains. Thus, subchronic (7 day) exposure to alcohol induces depressive-like characteristics in Wistar rats and exacerbates that of WKY rats. Chronic (14 day) exposure, however, also induces an anxiety-like effect in both strains. The depressive- and anxiety-like behaviors induced by alcohol were blocked by daily treatment with a tricyclic antidepressant. It may be suggested that prophylactic treatment of alcoholics with an antidepressant prior to detoxification may improve treatment outcome for alcoholism.
Collapse
Affiliation(s)
- Bruk Getachew
- Department of Pharmacology, College of Medicine, Howard University, 520 W Street NW, Washington, DC 20059, USA
| | | | | | | |
Collapse
|
25
|
Lee HS, Kim S, Choi I, Lee KU. Prevalence and risk factors associated with suicide ideation and attempts in korean college students. Psychiatry Investig 2008; 5:86-93. [PMID: 20046350 PMCID: PMC2796021 DOI: 10.4306/pi.2008.5.2.86] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. METHODS Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki's suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. RESULTS The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. CONCLUSION Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
Collapse
Affiliation(s)
- Hong-Seok Lee
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Inyoung Choi
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyuong-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|