Division of Psychiatry, University College London (UCL), London W1T 7NF, UK.
Camden and Islington NHS Foundation Trust, London NW1 0PE, UK.
Int J Environ Res Public Health. 2022 Oct 14;19(20):13245. doi: 10.3390/ijerph192013245.
Bereavement by suicide and other unnatural causes is associated with suicide but evidence regarding risk of substance misuse is inconsistent. This may be due to heterogeneity in patterns of alcohol or drug use after traumatic bereavement; some increasing use to cope with the loss and others reducing use. To highlight the problems of focussing on diagnostic thresholds when investigating substance use after traumatic loss, we aimed to test whether people bereaved by suicide or other unnatural causes are more likely to reduce or stop their substance use than people bereaved by sudden natural causes. Using multivariable logistic regression and data from an online survey of 1854 UK-based bereaved adults, we tested the association between bereavement by suicide and other unnatural causes and post-bereavement reduction/cessation in (i) alcohol and (ii) drug use. There were no group differences in the proportions who reduced/stopped alcohol use, but a significantly greater proportion of people bereaved by sudden unnatural causes reduced/stopped drug use post-bereavement than people bereaved by sudden natural causes (AOR = 2.61; 95% CI = 1.44-4.71; = 0.001; 4.1% versus 1.7%). In sub-group analyses this applied separately to people bereaved by suicide and non-suicide unnatural causes. Research into post-bereavement substance use should accommodate apparent divergent sub-diagnostic patterns.
自杀和其他非自然原因导致的丧亲与自杀有关,但关于物质滥用风险的证据并不一致。这可能是由于创伤性丧亲后酒精或药物使用模式的异质性所致;一些人增加使用量以应对丧失,而另一些人则减少使用量。为了强调在调查创伤性丧失后物质使用时关注诊断阈值的问题,我们旨在测试自杀或其他非自然原因导致的丧亲者是否比突发自然原因导致的丧亲者更有可能减少或停止其物质使用。我们使用多变量逻辑回归和来自 1854 名英国丧亲成年人在线调查的数据,测试了自杀和其他非自然原因导致的丧亲和丧亲后(i)酒精和(ii)药物使用减少/停止之间的关联。在减少/停止饮酒的比例方面,两组之间没有差异,但与突发自然原因导致的丧亲者相比,突发非自然原因导致的丧亲者丧亲后减少/停止药物使用的比例显著更高(AOR=2.61;95%CI=1.44-4.71;=0.001;4.1%对 1.7%)。在亚组分析中,这分别适用于自杀和非自杀非自然原因导致的丧亲者。丧亲后物质使用的研究应适应明显不同的亚诊断模式。