Carmel Adam, Ries Richard, West Imara I, Bumgardner Kristin, Roy-Byrne Peter
a Department of Psychiatry & Behavioral Sciences , University of Washington at Harborview Medical Center , Seattle , WA , USA.
b Massachusetts Mental Health Center, Division of Public Psychiatry, Beth Israel Deaconess Medical Center , Harvard Medical School , Boston , MA , USA.
Am J Drug Alcohol Abuse. 2016 May;42(3):351-7. doi: 10.3109/00952990.2015.1133634. Epub 2016 Feb 24.
There is an increased need to prepare primary care clinicians to effectively gauge the risk of suicidal behavior occurring within primary care patients who may abuse drugs, especially those served in safety-net settings.
The objectives of this paper were to explore suicide risk in a population of individuals endorsing recent drug use, and to describe patient demographic, medical, psychiatric, social, and substance use characteristics across different levels of suicide risk.
A total of 867 primary care patients with reported drug use in the previous 90 days were studied. Based upon their responses to two Addiction Severity Index questions, four suicide risk categories were constructed: (1) low risk; (2) moderate-low (suicidal ideation in the past 30 days); (3) moderate-high (history of a lifetime suicide attempt); and (4) high risk (history of a lifetime suicide attempt and suicidal ideation in the past 30 days). The association between suicide risk groups and demographic and clinical variables were assessed.
A total of 40% of primary care patients endorsing recent drug use reported a lifetime suicide attempt. Compared to individuals in other suicide risk groups, individuals at high suicide risk had higher rates of substance use severity, recently used two or more substances, and were more likely to have a comorbid psychiatric condition.
These findings indicate that the percentage of patients with suicide risk may be higher among patients with recent drug use. Primary care clinicians should be aware that they may be encountering patients with suicide risk among those with recent drug use.
越来越需要让初级保健临床医生有能力有效地评估可能滥用药物的初级保健患者出现自杀行为的风险，尤其是那些在安全网环境中接受治疗的患者。
本文的目的是探讨近期有吸毒行为的人群中的自杀风险，并描述不同自杀风险水平患者的人口统计学、医学、精神、社会和物质使用特征。
对总共867名在过去90天内有吸毒报告的初级保健患者进行了研究。根据他们对两个成瘾严重程度指数问题的回答，构建了四个自杀风险类别：（1）低风险；（2）中度低风险（过去30天内有自杀意念）；（3）中度高风险（有过终身自杀未遂史）；（4）高风险（有过终身自杀未遂史且过去30天内有自杀意念）。评估了自杀风险组与人口统计学和临床变量之间的关联。
在报告近期有吸毒行为的初级保健患者中，共有40%的人报告有过终身自杀未遂。与其他自杀风险组的个体相比，自杀高风险个体的物质使用严重程度更高，近期使用两种或更多种物质，并且更有可能患有共病精神疾病。
这些发现表明，近期有吸毒行为的患者中自杀风险患者的比例可能更高。初级保健临床医生应意识到，在近期有吸毒行为的患者中可能会遇到有自杀风险的患者。
