Landheim A S, Bakken K, Vaglum P
Department for Substance Abuse, Centre for Addiction Issues, Sanderud Hospital, Ottestad, Norway.
Eur Addict Res. 2006;12(2):102-8. doi: 10.1159/000090430.
The frequency of suicide attempts and clinical characteristics of attempters among poly-substance abusers and alcoholics were examined.
A consecutive sample (n = 260) of in- and outpatients from two Norwegian counties were assessed by Composite International Diagnostic Interview (Axis I disorders), Millon's Clinical Multiaxial Inventory (Axis II disorders) and the Norwegian National Client Assessment Form. When analysing the association between suicide attempters and the range of predictor variables, logistic regression analysis was conducted.
Almost half (47%) of the sample reported lifetime suicide attempts; significantly more frequently in poly-substance abusers (58%) than alcoholics (38%). A substance use disorder with duration of >or=15 years and an early onset (<18 years of age) were independently associated with being a suicide attempter after controlling for Axis I disorders. In addition, eating disorders, agoraphobia and major depression were strongly and independently associated with being a suicide attempter.
Attempts at preventing suicidal behaviour should not ignore the suicide risk among poly-substance abusers. In addition, prevention of suicidal behaviour demands a treatment programme focusing concomitantly on both addictive behaviour and comorbid psychiatric disorders.
研究多物质滥用者和酗酒者中自杀未遂的发生率及未遂者的临床特征。
采用综合国际诊断访谈(轴I障碍)、米隆临床多轴问卷(轴II障碍)和挪威国家客户评估表,对挪威两个郡的260名连续样本门诊和住院患者进行评估。在分析自杀未遂者与一系列预测变量之间的关联时,进行了逻辑回归分析。
近半数(47%)的样本报告有过自杀未遂经历;多物质滥用者(58%)的自杀未遂发生率显著高于酗酒者(38%)。在控制轴I障碍后,持续时间≥15年且起病较早(<18岁)的物质使用障碍与自杀未遂独立相关。此外,饮食失调、广场恐惧症和重度抑郁症与自杀未遂密切且独立相关。
预防自杀行为不应忽视多物质滥用者中的自杀风险。此外,预防自杀行为需要一个同时关注成瘾行为和共病精神障碍的治疗方案。