Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy.
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy.
Child Abuse Negl. 2024 May;151:106731. doi: 10.1016/j.chiabu.2024.106731. Epub 2024 Mar 19.
Suicide attempts (SA) are a public health concern because of increasing prevalence and clinical implications. Childhood trauma (CT) and emotion dysregulation (ED) have been proposed as predictors of SA, but few data are available in patients with Substance Use Disorder (SUD).
Our study aims to investigate the association of sociodemographic/clinical variables, CT typologies, and ED features with SA in SUD patients.
Subjects with SUD were screened in an outpatient setting. The final sample consisted of 226 patients, subdivided according to the presence of lifetime SA (SUD, n = 163 vs. SUD-SA, n = 63).
Participants were compared for sociodemographic and clinical information. CT and ED were assessed through the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS), respectively. We performed a mediation analysis to test the effect of CT and ED on SA.
Patients with a history of SA (27.9 %) displayed more psychiatric comorbidities (p = 0.002) and hospitalizations (p < 0.001), higher scores at CTQ-SF sexual abuse (p < 0.001) and DERS 'impulse' (p = 0.002), 'goals', 'non-acceptance', 'strategies' (p < 0.001) subscales. The relationship between CTQ-SF sexual abuse and SA was significantly mediated by DERS 'strategies' (p = 0.04; bootstrapped 95 % LLCI-ULCI = 0.004-0.024).
CT and different dimensions of ED were associated with SA in SUD patients. In our sample, the effects of childhood sexual abuse on SA were mediated by limited access to emotion regulation strategies. SUD patients are burdened with higher all-cause mortality, and CT and lifetime SA can worsen clinical outcomes. Clarifying the reciprocal interactions of psychopathological dimensions may help deliver targeted interventions and reduce suicide risk in specific populations.
自杀未遂 (SA) 是一个公共卫生关注点，因为其发生率不断增加且具有临床意义。童年创伤 (CT) 和情绪调节障碍 (ED) 已被提出作为自杀未遂的预测因素，但在物质使用障碍 (SUD) 患者中可用的数据很少。
我们的研究旨在调查 SUD 患者的社会人口统计学/临床变量、CT 类型和 ED 特征与 SA 的关联。
在门诊环境中筛选 SUD 患者。最终样本包括 226 名患者，根据是否存在终生 SA（SUD 组，n=163 与 SUD-SA 组，n=63）进行分组。
对参与者的社会人口统计学和临床信息进行比较。使用儿童创伤问卷-短表 (CTQ-SF) 和情绪调节困难量表 (DERS) 分别评估 CT 和 ED。我们进行了中介分析以测试 CT 和 ED 对 SA 的影响。
有自杀未遂史的患者（27.9%）表现出更多的精神共病（p=0.002）和住院治疗（p<0.001），CTQ-SF 性虐待（p<0.001）和 DERS '冲动'（p=0.002）、'目标'、'不接受'、'策略'（p<0.001）子量表的评分更高。CTQ-SF 性虐待与 SA 之间的关系显著受 DERS '策略'的中介（p=0.04；bootstrapped 95%LLCI-ULCI=0.004-0.024）。
CT 和 ED 的不同维度与 SUD 患者的 SA 相关。在我们的样本中，童年性虐待对 SA 的影响是通过有限的情绪调节策略的获得来介导的。SUD 患者的全因死亡率较高，而 CT 和终生 SA 会恶化临床结局。阐明精神病理维度的相互作用可能有助于为特定人群提供有针对性的干预措施并降低自杀风险。
