Comparative risk of suicide by specific substance use disorders: A national cohort study.
Comparative risk of suicide by specific substance use disorders: A national cohort study.
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DOI：
10.1016/j.jpsychires.2021.10.017
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发表时间：
2021-12
影响因子：
4.8
通讯作者：
Sundquist K
中科院分区：
文献类型：
--
作者：
Crump C;Sundquist J;Kendler KS;Edwards AC;Sundquist K
物质使用障碍(SODS)是自杀的重要危险因素，但人们对特定的SUD如何改变自杀风险知之甚少。我们首次在大量普通人群中检查了这些风险，以便于跨SUD进行比较。瑞典对6947,191名成年人进行了一项全国性的队列研究。通过2003-2016年间的住院、门诊和犯罪数据以及使用全国范围内的死亡数据并进行随访，确定了肥胖症(阿片类药物、镇静剂/催眠剂、迷幻剂、大麻、安非他明、可卡因和酒精使用障碍)。COX回归用于计算自杀死亡的危险比(HR)，同时调整社会人口学因素以及精神、SUD和躯体合并症。由未测量的共有家族(遗传和/或环境)因素评估的混杂兄弟姐妹分析。在7980万人年的跟踪调查中，15616人(0.2%)被确认为自杀死亡。所有肥胖症都与显著增加的风险相关，在调整协变量前后的比率分别为12-26倍和2.5-6.4倍。在调整了所有协变量后，阿片类药物使用障碍是最大的危险因素(HR，6.39；95%CI，5.53-7.38)(与其他任何SUD相比，P≤0.002)，其次是镇静/催眠药物使用障碍(4.62；4.06-5.27)(P≤0.009与除阿片或迷幻剂以外的任何其他SUD)。在控制了共同的家族因素后，大多数关联仍然存在，这与因果关系一致。在这个庞大的国家队列中，所有肥皂水都与自杀死亡风险显著增加有关，特别是阿片类药物和镇静剂/催眠药使用障碍。这些发现可能会改善风险分层，并为干预措施提供信息，以防止患有SUDS的高风险亚组的自杀。瑞典与特定肥皂水相关的自杀死亡的性别分层调整危险比(HRs)。DUD=药物使用障碍，SUD=物质使用障碍
Substance use disorders (SUDs) are important risk factors for suicide, yet little is known about how suicide risks vary by specific SUDs. We examined these risks for the first time in a large general population to facilitate comparisons across SUDs. A national cohort study was conducted of all 6,947,191 adults in Sweden. SUDs (opioid, sedative/hypnotic, hallucinogen, cannabis, amphetamine, cocaine, and alcohol use disorders) were identified using inpatient, outpatient, and crime data, and suicide deaths using nationwide death data with follow-up during 2003–2016. Cox regression was used to compute hazard ratios (HRs) for suicide death while adjusting for sociodemographic factors and psychiatric, SUD, and somatic comorbidities. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic and/or environmental) factors. In 79.8 million person-years of follow-up, 15,616 (0.2%) suicide deaths were identified. All SUDs were associated with significantly increased risks, with HRs ranging from 12- to 26-fold and 2.5- to 6.4-fold before and after adjusting for covariates, respectively. After adjusting for all covariates, opioid use disorder was the strongest risk factor (HR, 6.39; 95% CI, 5.53–7.38) (P≤0.002 compared with any other SUD), followed by sedative/hypnotic use disorder (4.62; 4.06–5.27) (P≤0.009 compared with any other SUD except opioid or hallucinogen). Most associations persisted after controlling for shared familial factors, consistent with causal effects. In this large national cohort, all SUDs were associated with significantly increased risks of suicide death, especially opioid and sedative/hypnotic use disorders. These findings may improve risk stratification and inform interventions to prevent suicide in the highest-risk subgroups with SUDs. Sex-stratified adjusted hazard ratios (HRs) for suicide death associated with specific SUDs, Sweden. DUD = drug use disorder, SUD = substance use disorder
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影响因子：
6.9
作者：
Kendler, K. S.;Ohlsson, H.;Sundquist, K.
通讯作者：
Sundquist, K.
影响因子：
3.7
作者：
Ferrari AJ;Norman RE;Freedman G;Baxter AJ;Pirkis JE;Harris MG;Page A;Carnahan E;Degenhardt L;Vos T;Whiteford HA
通讯作者：
Whiteford HA
影响因子：
24.9
作者：
Ivey-Stephenson, Asha Z.;Crosby, Alex E.;Kresnow-Sedacca, Marcie-jo
通讯作者：
Kresnow-Sedacca, Marcie-jo
影响因子：
12.7
作者：
Blow, Frederic C.;Bohnert, Amy S. B.;Knox, Kerry L.
通讯作者：
Knox, Kerry L.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y