Determinants of suicidal ideation: The role of substance use disorders

Author(s): Russo, J. E., RoyByrne, P. P., Ries, R. K., Cowley, D. S.

Journal/Book: J Clin Psychiat. 1997; 58: P O Box 240008, Memphis, TN 38124. Physicians Postgraduate Press. 510-515.

Abstract: Background: This study tested the hypothesis that the amount of psychoactive substance consumed (frequency and/or quantity), life problems resulting from this use, and a DSM-IV diagnosis of substance abuse/dependence are independent risk factors associated with increased suicidal ideation in a population of psychiatric inpatients with major depressive disorder. Method: 891 hospitalized patients with a primary diagnosis of nonpsychotic major depressive disorder (MDD) received a standardized, psychic trist-administered assessment battery. To examine the relationship between admission suicidality and demographic, psychiatric history, and admission variables, chi-square analyses were used for categorical data and one-way ANOVAs were used for continuous indices. Stepwise hierarchical multiple regression analyses were performed to determine the set of variables that was independently related to admission suicidality level. Results: Then was general agreement between our findings and previous literature in regard to the association between severity of Axis I diagnosis, depressed mood, hopelessness, male gender, unemployment, involuntary treatment, and alcohol/drug problems and higher suicidal ideation. In our sample of hospitalized patients with unipolar major depressive disorder, higher current drug and/or alcohol dependency and high current use of alcohol or other substances of abuse were independently associated with higher levels of suicidal ideation. Conclusion: This association with higher suicidal ideation lends support to the importance of treating patients for both alcohol/drug problems and depression in an effort to decrease their risk for future suicide. We hope that our findings will improve the care that patients with dual diagnoses receive.

Note: Article Pages KP, Univ Washington, Harborview Med Ctr, Dept Psychiat & Behav Sci, Box 359896, 325 9TH, Seattle,WA 98104 USA

Keyword(s): RISK-FACTORS; MAJOR DEPRESSION; ALCOHOL-ABUSE; BEHAVIOR; SCALE; SCHIZOPHRENIA; INPATIENTS; COCAINE; YOUNG

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