Morley Kirsten C, Sitharthan Gomathi, Haber Paul S, Tucker Peter, Sitharthan Thiagarajan
a NHMRC Centre for Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine , The University of Sydney , New South Wales , Australia.
b Health Sciences , The University of Sydney , New South Wales , Australia.
Subst Use Misuse. 2018 Sep 19;53(11):1811-1818. doi: 10.1080/10826084.2018.1435075. Epub 2018 Feb 8.
There is little research to distinguish those who attempt suicide and those who only consider suicide, and the role that substance use plays in this progression. We aim to describe clinical correlates of suicide attempters versus ideators in substance users. We examined characteristics of substance users (N = 185) that had either a suicide attempt within the last 6 months (n = 94) or were suicide ideators (n = 91). Suicide attempters displayed significant different clinical profiles to that of non-attemptors. Relative to ideators, attempters had greater scores on impulsivity, the brief psychiatric scale and more likely to be female and a recent psychostimulant user. Logistic regression revealed that male gender was associated with a decreased odds of a previous suicide attempt (OR = 0.37, p < 0.05) and greater impulsivity scores were associated with increased odds of an attempt (OR = 1.15, p < 0.05), although entering interaction terms diminished the role of impulsivity and revealed a significant interaction of alcohol use x depression. While impulsivity was a significant predictor of suicide attempt relative to depression or alcohol use alone, this reduced when considering interactions between psychological characteristics and substance use, whereby the effect of alcohol use on the likelihood of a recent suicide attempt varied at different levels of depression.
很少有研究能够区分自杀未遂者和仅考虑自杀者，以及物质使用在这一过程中所起的作用。我们旨在描述物质使用者中自杀未遂者与有自杀念头者的临床相关因素。我们研究了185名物质使用者的特征，其中在过去6个月内有过自杀未遂行为的有94人，有自杀念头的有91人。自杀未遂者与未尝试自杀者的临床特征存在显著差异。与有自杀念头者相比，自杀未遂者在冲动性、简易精神量表上得分更高，更有可能为女性且近期使用过精神兴奋剂。逻辑回归分析显示，男性性别与既往自杀未遂几率降低相关（比值比=0.37，p<0.05），更高的冲动性得分与自杀未遂几率增加相关（比值比=1.15，p<0.05），尽管纳入交互项后减弱了冲动性的作用，并揭示了酒精使用与抑郁之间的显著交互作用。虽然相对于单独的抑郁或酒精使用，冲动性是自杀未遂的一个重要预测因素，但在考虑心理特征与物质使用之间的相互作用时，这一作用减弱了，即酒精使用对近期自杀未遂可能性的影响在不同抑郁水平上有所不同。
