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Shiraly R, Jazayeri SA, Seifaei A, Jeihooni AK, Griffiths MD. Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study. Harm Reduct J 2024; 21:96. [PMID: 38755587 PMCID: PMC11097468 DOI: 10.1186/s12954-024-01015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/04/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. METHODS A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. RESULTS Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. CONCLUSION Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.
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Affiliation(s)
- Ramin Shiraly
- Community Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Amin Jazayeri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asal Seifaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Public Health Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Pigoni A, Delvecchio G, Turtulici N, Madonna D, Pietrini P, Cecchetti L, Brambilla P. Machine learning and the prediction of suicide in psychiatric populations: a systematic review. Transl Psychiatry 2024; 14:140. [PMID: 38461283 PMCID: PMC10925059 DOI: 10.1038/s41398-024-02852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
Machine learning (ML) has emerged as a promising tool to enhance suicidal prediction. However, as many large-sample studies mixed psychiatric and non-psychiatric populations, a formal psychiatric diagnosis emerged as a strong predictor of suicidal risk, overshadowing more subtle risk factors specific to distinct populations. To overcome this limitation, we conducted a systematic review of ML studies evaluating suicidal behaviors exclusively in psychiatric clinical populations. A systematic literature search was performed from inception through November 17, 2022 on PubMed, EMBASE, and Scopus following the PRISMA guidelines. Original research using ML techniques to assess the risk of suicide or predict suicide attempts in the psychiatric population were included. An assessment for bias risk was performed using the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines. About 1032 studies were retrieved, and 81 satisfied the inclusion criteria and were included for qualitative synthesis. Clinical and demographic features were the most frequently employed and random forest, support vector machine, and convolutional neural network performed better in terms of accuracy than other algorithms when directly compared. Despite heterogeneity in procedures, most studies reported an accuracy of 70% or greater based on features such as previous attempts, severity of the disorder, and pharmacological treatments. Although the evidence reported is promising, ML algorithms for suicidal prediction still present limitations, including the lack of neurobiological and imaging data and the lack of external validation samples. Overcoming these issues may lead to the development of models to adopt in clinical practice. Further research is warranted to boost a field that holds the potential to critically impact suicide mortality.
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Affiliation(s)
- Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nunzio Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Domenico Madonna
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Pietrini
- MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Luca Cecchetti
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Carretta RF, McKee SA, Rhee TG. Gender Differences in Risks of Suicide and Suicidal Behaviors in the USA: A Narrative Review. Curr Psychiatry Rep 2023; 25:809-824. [PMID: 37930559 PMCID: PMC11225381 DOI: 10.1007/s11920-023-01473-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE OF REVIEW We review recent research (2018-2023) on gender differences in suicidal behaviors (i.e., suicidal ideations and attempts, death by suicide). We examine research studies in the following areas: developmental period, substance use, and special populations (Veterans, sexual and gender minorities). RECENT FINDINGS Novel results were found in these different areas. For example, suicide rates for female youth are increasing at a faster rate relative to male youth. Further, some evidence suggests that heavy alcohol use/binge drinking is a significant and growing risk factor for suicidal behaviors in women. Military service may be a more significant risk factor for suicidal behaviors among male Veterans compared to female Veterans. Additionally, suicide rates are rising for gender minority youth/young adults. Recent research on gender differences in suicide outcomes demonstrates findings that align with previous research, as well as new insights on this important topic.
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Affiliation(s)
- Rachel F Carretta
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06511, USA
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06511, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06511, USA.
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, 06030, USA.
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Choi NG, Choi BY, Marti CNC, Baker DS. Cocaine-involved suspected suicide attempts in individuals age 50 and older reported to United States Poison Centers. Clin Toxicol (Phila) 2023; 61:602-610. [PMID: 37585276 PMCID: PMC10592320 DOI: 10.1080/15563650.2023.2244666] [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: 05/18/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
CONTEXT Despite a rapidly growing number of older cocaine users, the link between cocaine use and suicide attempt in older adults has not been examined. We examined associations between co-used other substances and (1) suspected suicide attempts versus other intentional misuse, and (2) major medical outcomes (major effect or death) of suspected suicide attempts and other intentional misuse. METHODS We used the 2015-2021 United States National Poison Data System (N = 5,191 cases age 50 and older). Descriptive statistics and generalized linear models for a Poisson distribution with a log link function were used to examine the study questions. RESULTS Cocaine exposures steadily increased from 2015 through 2021. Over the seven years, 52.3% and 47.7% were suicide attempts and other intentional misuse cases, respectively. Co-use of alcohol (incidence rate ratios = 1.24, 95% confidence interval = 1.14-1.35) and psychotropic (e.g., antidepressants: incidence rate ratios = 1.37, 95% confidence interval = 1.24-1.53) and cardiovascular medications were associated with a higher likelihood of suicide attempt, but co-use of prescription opioids, heroin, or other illicit drugs was associated with a lower likelihood of suicide attempt compared to other intentional misuse. Prescription opioids and amfetamine were associated with a higher likelihood of major effect or death in both suicide attempts and intentional misuse and heroin use and injection use were associated with a higher likelihood of major effect/death among intentional misuse cases. CONCLUSIONS These findings show that significant proportions of older cocaine users who attempted suicide also used psychotropic and cardiovascular medications. We suggest that healthcare providers screen for suicidal ideation among cocaine users, with special attention to an increased risk of suicide attempts among those who co-use cocaine with alcohol and psychotropic and other prescription medications.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine & Bayhealth Medical Center, Dover, DE, USA
| | - C. Nathan C. Marti
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Roza TH, Seibel GDS, Recamonde-Mendoza M, Lotufo PA, Benseñor IM, Passos IC, Brunoni AR. Suicide risk classification with machine learning techniques in a large Brazilian community sample. Psychiatry Res 2023; 325:115258. [PMID: 37263086 DOI: 10.1016/j.psychres.2023.115258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023]
Abstract
Even though suicide is a relatively preventable poor outcome, its prediction remains an elusive task. The main goal of this study was to develop machine learning classifiers to identify increased suicide risk in Brazilians with common mental disorders. With the use of clinical and sociodemographic baseline data (n = 4039 adult participants) from a large Brazilian community sample, we developed several models (Elastic Net, Random Forests, Naïve Bayes, and ensemble) for the classification of increased suicide risk among individuals with common mental disorders. 1120 participants (27.7%) presented increased suicide risk. The Random Forests model achieved the best AUC ROC (0.814), followed by Naive Bayes (0.798) and Elastic Net (0.773). Sensitivity varied from 0.922 (Naive Bayes) to 0.630 (Random Forests), while specificity varied from 0.792 (Random Forests) to 0.473 (Naive Bayes). The ensemble model presented an AUC ROC of 0.811, sensitivity of 0.899, and specificity of 0.510. Features representing depression symptoms were the most relevant for the classification of increased suicide risk. Some of our models presented good performance metrics in the classification of increased suicide risk in the investigated sample, which can provide the means to early preventive interventions.
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Affiliation(s)
- Thiago Henrique Roza
- Department of Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil; Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Gabriel de Souza Seibel
- Institute of Informatics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Mariana Recamonde-Mendoza
- Institute of Informatics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Bioinformatics Core, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
| | - Paulo A Lotufo
- Department of Internal Medicine, Faculty of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
| | - Isabela M Benseñor
- Department of Internal Medicine, Faculty of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Andre Russowsky Brunoni
- Department of Psychiatry and Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
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Rooney B, Sobiecka P, Rock K, Copeland C. From Bumps to Binges: Overview of Deaths Associated with Cocaine in England, Wales and Northern Ireland (2000-2019). J Anal Toxicol 2023; 47:207-215. [PMID: 36611264 PMCID: PMC10037635 DOI: 10.1093/jat/bkad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/24/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
The UK, as the "cocaine capital of Europe," currently accounts for ∼75% of all cocaine-related hospital admissions in Europe. This study aims to analyze the trends in cocaine-related deaths in England, Wales and Northern Ireland over 20 years (2000-2019). Cases reported to the National Programme on Substance Abuse Deaths (NPSAD) occurring between 2000 and 2019 where cocaine was detected at post-mortem (PM) were extracted for analysis. A total of 5,339 cases were retrieved, with an increase in the rate of reporting over time. Cocaine was deemed a cause of death and quantified in PM blood samples along with its major metabolite benzoylecgonine in 685 cases. Of these 685 cases, 25% (n = 170/685) occurred following acute use, 22% (n = 154/685) following chronic/binge use, 40% (n = 271/685) in combination with morphine, 4% (n = 29/685) in drug packer/swallower circumstances and 9% (n = 61/685) in a suicide context. Cardiac complications were evident in 22% of cases (n = 154/685). The average concentration of cocaine detected in cardiac cases (900 ng/mL) was considerably lower than that detected in cases where acute (19,100 ng/mL) or chronic/binge (6,200 ng/mL) dosing was evident. This is the first cocaine-related mortality study in these geographical areas. Deaths following cocaine use continue to rise despite its Class A drug listing in the UK. While underlying and external risk factors including polydrug use, cardiac complications and mental health can all contribute to the incidence of fatal drug toxicity following cocaine use, this study demonstrates that the risk of a cocaine overdose cannot be attributed to a specific blood concentration range.
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Affiliation(s)
- Brian Rooney
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, London KT1 2EE, UK
| | - Pola Sobiecka
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, London KT1 2EE, UK
| | - Kirsten Rock
- Institute of Pharmaceutical Sciences, King's College London, Stamford St., London SE1 9NQ, UK
- National Programme on Substance Abuse Deaths, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Caroline Copeland
- Institute of Pharmaceutical Sciences, King's College London, Stamford St., London SE1 9NQ, UK
- National Programme on Substance Abuse Deaths, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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Abreu LCC, Conceição SDS, de Carvalho DSB, Machado AC, Lyrio AO, Souza ES, Souza CS, de Matos PJDS, Batista JET, Gomes JDA, Hintz AM, Pereira PPDS, da Cruz SS, Gomes-Filho IS, Figueiredo ACMG. Factors Associated with Cocaine Consumption among Suicide Victim. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14309. [PMID: 36361188 PMCID: PMC9654489 DOI: 10.3390/ijerph192114309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Cocaine use is an increasingly frequent event, especially in young people, and can cause irreversible consequences, such as suicide. To evaluate the factors associated with cocaine use in the moments preceding to suicide. This is a population-based, cross-sectional, and analytical study conducted in the Brazilian Federal District by researchers from the Department of Health and the Civil Police Institute of Criminalistics. All people who died due to suicide in 2018 were included in the survey. Cocaine use was considered the dependent variable, and robust Poisson regression was performed to estimate the crude and adjusted prevalence ratios and their respective population confidence intervals. In 2018, 12,157 deaths were recorded, of which suicide accounted for 1.56% of all deaths. It was observed that being between 25 and 44 years old, male, and under the influence of alcohol or cannabis, had a strong positive association with cocaine consumption among suicide victims. Males, people with black skin, with lower level of education, with employment, and who were under the effect of the use of cannabis and/or alcohol in the previous hours of death had a higher propensity to consume cocaine immediately before suicide, with a moderate to strong magnitude of prevalence ratio. The findings of this research indicated the need for monitoring, by health services, of people most vulnerable to suicide through the consumption of psychoactive substances.
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Affiliation(s)
| | | | | | - Ana Cristina Machado
- Department of Public Health of the Federal District, Brasília 70390-125, Federal District, Brazil
| | - Amanda Oliveira Lyrio
- Department of Health of University of Brasilia, Brasília 70910-900, Federal District, Brazil
| | - Elivan Silva Souza
- Department of Health of University of Brasilia, Brasília 70910-900, Federal District, Brazil
| | - Cauê Silva Souza
- Health Sciences Teaching and Research Foundation’s, Brasília 70710-907, Federal District, Brazil
| | | | | | | | - Alexandre Marcelo Hintz
- Department of Health, Feira de Santana State University, Feira de Santana 44036-900, Bahia, Brazil
| | | | - Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo of Bahia, Santo Antônio de Jesus 44430-622, Bahia, Brazil
| | - Isaac Suzart Gomes-Filho
- Department of Health, Feira de Santana State University, Feira de Santana 44036-900, Bahia, Brazil
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Trettel ACPT, Muraro AP, Oliveira ECD, Nascimento VFD, Andrade ACDS, Santos ESD, Espinosa MM, Pillon SC. Factors associated with suicidal ideation during the COVID-19 pandemic in a population in the Brazilian Legal Amazon. CIENCIA & SAUDE COLETIVA 2022; 27:3157-3170. [PMID: 35894327 DOI: 10.1590/1413-81232022278.04972022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
This article aims to analyze the factors associated with suicidal ideation in the COVID-19 pandemic. A cross-sectional home-based survey, with three-stage cluster sampling, was conducted with 4,203 adults from ten municipalities in the Mato Grosso, Brazil. The data collection was carried households to assessment of sociodemographic characteristics, substance use and behavior in the pandemic. The Level 1 Symptom Cross Scale was used to identify suicidal ideation and aspects of mental health (somatic symptoms, sleep disturbances, dissociation, depression, anger, mania, anxiety, thoughts, substance use and memory). Chemiluminescence was used to detect IgG anti-SARS-CoV-2 antibodies. The prevalence of suicidal ideation was 19.2%, and the associated with increased consumption of alcohol (RP=1.16), smoking (RP=1.30), COVID-19 symptoms (RP=1.03), having one's life affected (RP=1.04), mental illness (RP=1.09) somatic symptoms (RP=1.15), sleep disturbance (RP=1.30), dissociation (RP=1.24), depression (RP=1.24), anger (RP=1.11), anxiety (RP=1.26), substance use (RP=1.19), drug prescription use (RP=1.18) and memory (RP=1.87). Highlights the high prevalence of suicidal ideation related to COVID-19 symptoms, changes in behavior post-pandemic and mental health factors.
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Affiliation(s)
- Ana Cláudia Pereira Terças Trettel
- Departamento de Enfermagem, Campus Tangará da Serra, Universidade do Estado de Mato Grosso. MT 358, Jardim Industrial. 78300-000 Tangará da Serra MT Brasil.
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso (UFMT). Cuiabá MT Brasil
| | | | - Vagner Ferreira do Nascimento
- Departamento de Enfermagem, Campus Tangará da Serra, Universidade do Estado de Mato Grosso. MT 358, Jardim Industrial. 78300-000 Tangará da Serra MT Brasil.
| | | | | | | | - Sandra Cristina Pillon
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto SP Brasil
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Moçambique M, Hoffmann A, Roglio VS, Kessler FH, Dalbosco C, Schuch JB, Pechansky F. Prevalence of suicide in cocaine users accessing health services: a systematic review and meta-analysis. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 44. [PMID: 35751594 PMCID: PMC9375660 DOI: 10.47626/1516-4446-2021-2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/19/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study reviewed and analyzed the prevalence of suicidal behaviors among cocaine users who sought health services. METHODS This is a systematic review and meta-analysis of studies published until January 2021. PubMed/MEDLINE, Scopus, Embase, PsycINFO, and LILACS were searched. The inclusion criteria were observational (retrospective or prospective), case-control, and/or cross-sectional reports that contained samples of cocaine users aged over 14 years who were assessed in health facilities or were in treatment. The random-effects model was used to calculate the overall prevalence of suicidal behavior with a 95% confidence interval. Subgroup analysis was conducted to investigate sources of heterogeneity. RESULTS Twenty articles were included, yielding a total of 2,252 cocaine users. The estimated prevalence was 43.59% (95%CI 31.10-57.38) for suicidal ideation and 27.71% (95%CI 21.63-34.73)for suicide attempts. High heterogeneity was found between studies for both outcomes (I² ≥ 93%), although subgroup analysis considering the quality of the studies showed a significant difference in suicide attempts (p = 0.03). CONCLUSION : Cocaine use can be considered a risk factor for suicidal behavior, and prevention and early screening measures should be implemented to facilitate adequate treatment.
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Affiliation(s)
- Milton Moçambique
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Aline Hoffmann
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Vinícius S. Roglio
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Felix H.P. Kessler
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Carla Dalbosco
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jaqueline B. Schuch
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisas em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
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10
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Zerdazi EH, Curis E, Karsinti E, Icick R, Fortias M, Batel P, Cottencin O, Orizet C, Gay A, Coeuru P, Deschenau A, Lack P, Moisan D, Pelissier-Alicot AL, Plat A, Trabut JB, Kousignian I, Boumendil L, Vicaut E, Prince N, Laplanche JL, Bellivier F, Lépine JP, Marie-Claire C, Brousse G, Vorspan F, Bloch V. Occurrence and severity of cocaine-induced hallucinations: Two distinct phenotypes with shared clinical factors but specific genetic risk factors. Drug Alcohol Depend 2022; 232:109270. [PMID: 35124387 DOI: 10.1016/j.drugalcdep.2022.109270] [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: 08/16/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 11/15/2022]
Abstract
UNLABELLED Cocaine-induced transient hallucinations (CIH) are a frequent complication following cocaine intake that is associated with addiction severity. METHODS Two hundred and forty-two non-psychotic and Caucasian lifetime cocaine users were included in a French multicentric study. Clinical variables and dopamine pathway genotype data were extracted and tested with CIH scores using a zero-inflated binomial model, which allows for the exploration of factors associated with occurrence and severity separately. RESULTS Cocaine dependence (poccurrence= 6.18 × 10-5, pseverity= 9.25 × 10-8), number of cocaine dependence DSM IV-Tr criteria (poccurrence= 1.22 × 10-7, pseverity= 5.09 × 10-6), and frequency of intake during the worst period of misuse (poccurrence= 8.51 × 10-04, pseverity= 0.04) were associated with greater occurrence and higher severity of CIH. The genetic associations did not yield significant results after correction for multiple tests. However, some nominal associations of SNPs mapped to the VMAT2, DBH, DRD1, and DRD2 genes were significant. In the multivariate model, the significant variables were the number of cocaine dependence criteria, lifetime alcohol dependence, and the nominally associated SNPs. CONCLUSION Our study shows that CIH occurrence and severity are two distinct phenotypes, with shared clinical risk factors; however, they likely do not share the same genetic background.
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Affiliation(s)
- El-Hadi Zerdazi
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Emile ROUX, Service d'addictologie, Limeil Brévannes 94450, France.
| | - Emmanuel Curis
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Emily Karsinti
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France; Université Paris Nanterre, Laboratoire Clipsyd, Nanterre 92000, France
| | - Romain Icick
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Maeva Fortias
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Philippe Batel
- Centre Hospitalier Camille Claudel, Service d'Addictologie de la Charente, La Couronne 16400, France
| | - Olivier Cottencin
- University of Lille, Inserm U-1172, CHU Lille, Department of Psychiatry and Addiction Medicine, Lille 59000, France
| | - Cyrille Orizet
- APHP, GHU Centre-Université de Paris, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris 75015, France
| | - Aurélia Gay
- CHU Saint-Etienne, Service d'Addictologie, Saint-Etienne 42000, France
| | | | - Alice Deschenau
- Hôpital Paul Guiraud, CSAPA Clinique Liberté, Ivry-sur-Seine 94200, France
| | - Philippe Lack
- Hôpital de la Croix Rousse, CSAPA, Lyon 69004, France
| | - Delphine Moisan
- APHP, GHU Nord-Université de Paris, Hôpital Beaujon, UTAMA, Clichy 92110, France
| | - Anne-Laure Pelissier-Alicot
- APHM, CHU La Timone, Service de Médecine légale, Aix-Marseille Université, Faculté de Médecine, Marseille 13385, France
| | - Arnaud Plat
- APHP, GHU Nord-Université de Paris, Hôpital Beaujon, UTAMA, Clichy 92110, France
| | - Jean-Baptiste Trabut
- APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Emile ROUX, Service d'addictologie, Limeil Brévannes 94450, France
| | - Isabelle Kousignian
- EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Luana Boumendil
- EA 7537 BioSTM, Faculté de Pharmacie, Université Paris Descartes, USPC, Paris 75006, France
| | - Eric Vicaut
- APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Unité de Recherche Clinique, Paris 75010, France
| | - Nathalie Prince
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Jean-Louis Laplanche
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Lariboisière, DMU BioGeM, Département de Biochimie et Biologie Moléculaire, Paris 75010, France
| | - Frank Bellivier
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Jean-Pierre Lépine
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Cynthia Marie-Claire
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service d'Addictologie et Université d'Auvergne EA 7280, UFR de Médecine, Clermont-Ferrand 63000, France
| | - Florence Vorspan
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologigue, Paris 75010, France
| | - Vanessa Bloch
- Université de Paris, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris F-75006, France; APHP, GHU Nord-Université de Paris, Hôpital Fernand Widal, Pharmacie Hospitalière, Paris 75010, France
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11
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Icick R, Karsinti E, Brousse G, Chrétienneau C, Trabut JB, Belforte B, Coeuru P, Moisan D, Deschenau A, Cottencin O, Gay A, Lack P, Pelissier-Alicot AL, Dupuy G, Fortias M, Etain B, Lépine JP, Laplanche JL, Bellivier F, Vorspan F, Bloch V. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Subst Abus 2021; 43:623-632. [PMID: 34597243 DOI: 10.1080/08897077.2021.1975875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Suicide attempts have been associated with both cocaine use disorder (CocUD) and childhood trauma. We investigated how childhood trauma is an independent risk factor for serious and recurrent suicide attempts in CocUD. Method: 298 outpatients (23% women) with CocUD underwent standardized assessments of substance dependence (Diagnostic and Statistical Manual-mental disorders, fourth edition, text revised), impulsiveness, resilience, and childhood trauma, using validated tools. Suicide attempts history was categorized as single vs. recurrent or non-serious vs. serious depending on the lifetime number of suicide attempts and the potential or actual lethality of the worst attempt reported, respectively. Bivariate and multinomial regression analyses were used to characterize which childhood trauma patterns were associated with the suicide attempts groups. Results: 58% of CocUD patients reported childhood trauma. Recurrent and serious suicide attempts clustered together and were thus combined into "severe SA." Severe suicide attempt risk increased proportionally to the number of childhood traumas (test for trend, p = 9 × 10-7). Non-severe suicide attempt risk increased with impulsiveness and decreased with resilience. In multinomial regression models, a higher number of traumas and emotional abuse were independently and only associated with severe vs. non-severe suicide attempts (effect size = 0.82, AUC = 0.7). The study was limited by its cross-sectional design. Conclusion: These preferential associations between childhood trauma and severe suicide attempts warrant specific monitoring of suicide attempts risk in CocUD, regardless of the severity of addiction profiles.
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Affiliation(s)
- Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Emily Karsinti
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,ED139, Laboratoire CLIPSYD, Paris Nanterre University, Nanterre, France
| | - Georges Brousse
- INSERM UMR-1107, Neuro-Dol, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Clara Chrétienneau
- INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France
| | | | - Beatriz Belforte
- APHP, Hôpital Européen Georges Pompidou, CSAPA Monte-Cristo, Paris, France
| | | | | | | | - Olivier Cottencin
- Université de Lille, CHU Lille - Psychiaty and Addiction Medicine Department, INSERM U1172 - Lille Neuroscience & Cognition Centre (LiNC), Plasticity & SubjectivitY team, Lille, France
| | - Aurélia Gay
- Service d'Addictologie, CHU St Etienne, Saint Etienne, France
| | | | | | - Gaël Dupuy
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Maeva Fortias
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Pierre Lépine
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Jean-Louis Laplanche
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
| | - Vanessa Bloch
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, "Therapeutic Optimization in Neuropsychopharmacology", Paris, France.,INSERM UMR-S1144, Université de Paris, Paris, France
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