Smith Julia L, McInnis Melvin G, Sperry Sarah H
Department of Psychiatry, University of Michigan, USA.
Department of Psychiatry, University of Michigan, USA.
Psychiatry Res. 2025 Feb;344:116357. doi: 10.1016/j.psychres.2025.116357. Epub 2025 Jan 6.
Across bipolar disorders (BSDs), alcohol and substance use and suicidal ideation (SI) contribute to increased rates of morbidity and mortality. The goal of the present study was to investigate temporal relationships between the intensity/frequency (I/F) of use and impairment related to alcohol and substance use and SI in a longitudinal BSD cohort.
Participants with BDI (n=565), BDII (n=162), and BD NOS (n=61) were included (median enrollment=72 months). Alcohol and substance use were measured using a modified version of the AUDIT administered every 6 months. SI was measured every 2 months using item 9 from the PHQ-9. Linear mixed effects models tested concurrent associations and Dynamic Structural Equation Models tested prospective associations between alcohol and substance use I/F and impairment with SI.
Cocaine I/F and alcohol and substance use impairment were concurrently associated with SI. When a person had more frequent and intense cannabis use compared to average, they had higher SI at the next timepoint. When individuals experienced more alcohol and substance use impairment than average, they had higher SI at the next timepoint.
I/F of cannabis use and alcohol and substance use impairment appear to lead to future increases in SI for those with BSDs.
在双相情感障碍（BSD）中，酒精和物质使用以及自杀意念（SI）会导致发病率和死亡率上升。本研究的目的是在一个纵向BSD队列中，调查酒精和物质使用强度/频率（I/F）与相关损害及SI之间的时间关系。
纳入了双相I型障碍（BDI，n = 565）、双相II型障碍（BDII，n = 162）和未特定型双相障碍（BD NOS，n = 61）的参与者（中位入组时间 = 72个月）。每6个月使用改良版酒精使用障碍识别测试（AUDIT）测量酒精和物质使用情况。每2个月使用患者健康问卷-9（PHQ-9）的第9项测量SI。线性混合效应模型测试同时期关联，动态结构方程模型测试酒精和物质使用I/F与SI损害之间的前瞻性关联。
可卡因I/F以及酒精和物质使用损害与SI同时期相关。当一个人使用大麻的频率和强度高于平均水平时，他们在下一个时间点的SI更高。当个体经历的酒精和物质使用损害高于平均水平时，他们在下一个时间点的SI更高。
对于患有BSD的人来说，大麻使用的I/F以及酒精和物质使用损害似乎会导致未来SI增加。
