Agrawal Arpana, Tillman Rebecca, Grucza Richard A, Nelson Elliot C, McCutcheon Vivia V, Few Lauren, Conner Kenneth R, Lynskey Michael T, Dick Danielle M, Edenberg Howard J, Hesselbrock Victor M, Kramer John R, Kuperman Samuel, Nurnberger John I, Schuckit Marc A, Porjesz Bernice, Bucholz Kathleen K
Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
J Affect Disord. 2017 Apr 15;213:96-104. doi: 10.1016/j.jad.2016.12.060. Epub 2017 Feb 3.
Substance use and misuse and suicidal thoughts and behaviors tend to co-occur. The purpose of this study was to examine whether (a) suicidal ideation and attempt are related to onset of alcohol, nicotine and cannabis use and dependence; (b) early use of alcohol, nicotine and cannabis is associated with onset of suicidal ideation and attempt; and (c) whether these associations persist while controlling for covariates, such as family history of alcohol problems, major depression and other internalizing and externalizing disorders.
The prospective cohort of the Collaborative Study of the Genetics of Alcoholism (COGA; N=3277) was used. Cross-sectional and discrete time logistic regression (i.e. survival) analyses examined associations between suicidal ideation and attempt and onset of alcohol, nicotine and cannabis use and dependence. Survival models also examined whether individual early substance use was related to onset of ideation and attempt.
Ideation was related to 0.71-0.77 odds of onset of subsequent alcohol, nicotine and cannabis use. Attempt was associated with 1.44-1.61 odds of later alcohol, nicotine and cannabis dependence, even after accounting for covariates. Evidence for early substance use being related to subsequent onset of ideation or attempt was limited. Several sex and race differences emerged.
The sample was ascertained for family history of alcoholism; not all participants had been followed up allowing for censored observations; reporting bias.
Suicide attempts are associated with increased likelihood of onset of substance dependence.
物质使用与滥用以及自杀念头和行为往往同时出现。本研究的目的是检验：（a）自杀意念和企图是否与酒精、尼古丁和大麻使用及依赖的开始有关；（b）酒精、尼古丁和大麻的早期使用是否与自杀意念和企图的开始有关；以及（c）在控制协变量（如酒精问题家族史、重度抑郁症以及其他内化和外化障碍）时，这些关联是否仍然存在。
使用酒精中毒遗传学合作研究（COGA；N = 3277）的前瞻性队列。横断面和离散时间逻辑回归（即生存）分析检验了自杀意念和企图与酒精、尼古丁和大麻使用及依赖开始之间的关联。生存模型还检验了个体早期物质使用是否与意念和企图的开始有关。
意念与随后酒精、尼古丁和大麻使用开始的几率为0.71 - 0.77相关。即使在考虑协变量后，企图与后来酒精、尼古丁和大麻依赖的几率为1.44 - 1.61相关。早期物质使用与随后意念或企图开始相关的证据有限。出现了一些性别和种族差异。
样本是根据酒精中毒家族史确定的；并非所有参与者都得到随访，存在删失观察；存在报告偏倚。
自杀企图与物质依赖开始可能性增加有关。
