Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMC Psychiatry. 2022 Mar 15;22(1):181. doi: 10.1186/s12888-022-03829-y.
Death by suicide in patients enrolled in opioid agonist therapy (OAT) is a major clinical concern. However, little knowledge exists regarding suicide attempts in this patient group. This study presents the lifetime prevalence of suicide attempts and the associations between suicide attempts and clinical and sociodemographic variables such as education, sex, early onset of substance use (< 13 years of age), substance use patterns, and injecting substance use among patients receiving OAT.
We used data from a cohort of OAT patients in Norway obtained from a health assessment of self-reported suicide attempts and sociodemographic and clinical factors. A total of 595 patients receiving OAT were assessed from 2016 to 2020. A binary logistic regression analysis was performed and reported with an unadjusted odds ratio and 95% confidence intervals (OR). The purpose of this assessment was to analyze associations between suicide attempts and substance use patterns as well as the injection of substances during the 30 days leading up to the health assessment. A negative binomial regression analysis with an incidence rate ratio and 95% confidence intervals (IRR) was performed to investigate sex, education, early onset of substance use, and the number of suicide attempts.
Forty-one percent of the OAT patients had attempted to die by suicide at least once during their lifetime. An early onset of substance use was strongly associated with the suicide attempts (IRR: 1.7, 1.3-2.2). No significant association was found between suicide attempts and sex (IRR: 1.2, 0.9-1.6) or education (IRR: 0.6, 0.2-2.1). Likewise, no association was identified between suicide attempts and injecting substance use (OR: 0.9, 0.6-1.3), nor using alcohol (OR: 0.9, 0.7-1.3), amphetamines (OR: 1.0, 0.7-1.3), benzodiazepines (OR: 1.0, 0.7-1.4), cannabis (OR: 1.2, 0.9-1.7), cocaine (OR: 1.3, 0.6-3.0), or opioids (OR: 1.4, 0.9-2.0).
The lifetime prevalence of suicide attempts was alarmingly high in the OAT population. An early onset of substance use seemed to be an important risk factor for suicide attempts. There was a non-significant association to more current use of opioids among OAT patients with previous suicide attempts.
在接受阿片类药物激动剂治疗（OAT）的患者中，自杀死亡是一个主要的临床关注点。然而，关于这个患者群体的自杀企图，我们知之甚少。本研究介绍了接受 OAT 治疗的患者一生中自杀企图的发生率，以及自杀企图与临床和社会人口学变量（如教育程度、性别、物质使用的早期开始年龄（<13 岁）、物质使用模式以及在接受 OAT 治疗期间使用注射物质）之间的关联。
我们使用了来自挪威 OAT 患者队列的数据，这些数据是通过对自我报告的自杀企图以及社会人口学和临床因素进行健康评估获得的。2016 年至 2020 年期间，共评估了 595 名接受 OAT 的患者。采用二元逻辑回归分析，报告未调整的优势比和 95%置信区间（OR）。本评估的目的是分析自杀企图与物质使用模式之间的关联，以及在健康评估前 30 天内使用物质和注射物质的情况。采用负二项回归分析，计算发病率比和 95%置信区间（IRR），以研究性别、教育程度、物质使用的早期开始年龄和自杀企图的次数。
41%的 OAT 患者一生中至少有过一次自杀企图。物质使用的早期开始与自杀企图有很强的关联（IRR：1.7，1.3-2.2）。自杀企图与性别（IRR：1.2，0.9-1.6）或教育程度（IRR：0.6，0.2-2.1）之间无显著关联。同样，自杀企图与注射物质使用（OR：0.9，0.6-1.3）、使用酒精（OR：0.9，0.7-1.3）、安非他命（OR：1.0，0.7-1.3）、苯二氮卓类（OR：1.0，0.7-1.4）、大麻（OR：1.2，0.9-1.7）、可卡因（OR：1.3，0.6-3.0）或阿片类药物（OR：1.4，0.9-2.0）之间也没有关联。
在 OAT 人群中，自杀企图的终生发生率高得惊人。物质使用的早期开始似乎是自杀企图的一个重要危险因素。在有自杀企图的 OAT 患者中，与当前更频繁使用阿片类药物之间存在非显著关联。
