Spaderna Max, Rosenthal Elana, Kang Sun Jung, Eyasu Rahwa, Ebah Emade, Ogbumbadiugha Onyinyechi, Bijole Phyllis, Cover Amelia, Davis Ashley, Zoltick Meredith, Kottilil Sita, Mount Julia, Gannon Catherine, Stevens Jasmine, Garrett Grace, Derenoncourt Meghan, Liu Tina, Horowitz Lisa, Pao Maryland, Kattakuzhy Sarah
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Am J Addict. 2025 Jul;34(4):440-449. doi: 10.1111/ajad.70027. Epub 2025 Mar 11.
Few studies have longitudinally investigated suicide risk (SR) in opioid use disorder (OUD). This investigation administered three screening tools to individuals with OUD to compare rates of and variables associated with SR over 12 months.
121 individuals meeting criteria for OUD within the past 3 years were administered Item #9 of Patient Health Questionnaire-9 (PHQ-Item-9), the twelfth item of DSM-5-TR Self-Rated Level 1 Cross-Cutting Measure (CCSM-Item-12), and the Ask Suicide-Screening Questions (ASQ) to detect SR at Day 0 and Months 6 and 12. A partitioned generalized methods of moment (GMM) model identified variables associated with SR.
At Day 0, screen-positive rates for SR were 30% for ASQ, 12.4% for PHQ-Item-9, and 4.1% for CCSM-Item-12. Rates were similar at Months 6 and 12. Variables significantly associated with SR by PHQ-Item-9 were intentional overdose history (p < .001), poor sleep (p < .001), meeting criteria for psychosis (p < .001), and meeting criteria for mania (p = .005). Variables significantly associated with SR by ASQ were intentional overdose history (p < .001), female gender (p = .003), meeting criteria for psychosis (p = .001), and total PHQ-9 score (p = .032). Too few participants endorsed SR by CCSM-Item-12 to be included.
In the OUD population, screening positive for SR was unchanged over 1 year, but detection rates varied by screening tool. History of intentional opioid overdose is independently associated with screening positive for SR.
This is the first study to evaluate SR in the OUD population using more than one screening tool, and to show an association of history of intentional opioid overdose with SR.
很少有研究对阿片类物质使用障碍（OUD）患者的自杀风险（SR）进行纵向调查。本研究对患有OUD的个体使用了三种筛查工具，以比较12个月内SR的发生率及相关变量。
对过去3年内符合OUD标准的121名个体，在第0天、第6个月和第12个月时使用患者健康问卷-9（PHQ-9）的第9项、精神疾病诊断与统计手册第5版修订版（DSM-5-TR）一级跨诊断症状自评量表（CCSM）的第12项以及自杀筛查问题（ASQ）来检测SR。采用分段广义矩估计（GMM）模型确定与SR相关的变量。
在第0天，ASQ的SR筛查阳性率为30%，PHQ-9第9项为12.4%，CCSM第12项为4.1%。在第6个月和第12个月时发生率相似。PHQ-9中与SR显著相关的变量有故意过量用药史（p < 0.001）、睡眠不佳（p < 0.001）、符合精神病标准（p < 0.001）以及符合躁狂标准（p = 0.005）。ASQ中与SR显著相关的变量有故意过量用药史（p < 0.001）、女性（p = 0.003）、符合精神病标准（p = 0.001）以及PHQ-9总分（p = 0.032）。因认可CCSM第12项筛查出SR的参与者过少而未纳入分析。
在OUD人群中，SR筛查阳性率在1年内无变化，但不同筛查工具的检测率有所不同。故意阿片类药物过量用药史与SR筛查阳性独立相关。
这是第一项使用多种筛查工具评估OUD人群中SR，并显示故意阿片类药物过量用药史与SR之间存在关联的研究。
