Associations of substance use, abuse, and dependence with subsequent suicidal behavior.
Associations of substance use, abuse, and dependence with subsequent suicidal behavior.
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DOI：
10.1093/oxfordjournals.aje.a010278
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发表时间：
2000-04
影响因子：
5
通讯作者：
Guiherme Borges;E. Walters;Ronald C. Kessler
中科院分区：
文献类型：
--
作者：
Guiherme Borges;E. Walters;Ronald C. Kessler
一般人口调查数据用于分解药物滥用障碍与自杀企图的关联，以便评估有关导致这些关联的过程的许多假设。数据来自美国国家合并症调查（1990-1992）。离散时间生存分析用于研究回顾性报告的先前物质使用、滥用和依赖对预测自杀行为首次发作的影响。在控制了社会人口统计学和共病精神障碍后，酒精和药物的使用可以预测随后的自杀企图。对于当前非用户来说，以前的使用情况并不是一个重要的预测因素。滥用和依赖是所考虑的 10 种物质中的三种（酒精、吸入剂和海洛因）使用者的重要预测因素。在预测自杀行为时，所用物质的数量比所用物质的类型更重要。分解表明，使用的影响主要在于自杀意念和自杀意念者的非计划尝试。相比之下，使用对创意者的自杀计划和计划尝试的影响并不显着。临床医生需要意识到，即使没有滥用或依赖，当前的药物使用也是思想家计划外自杀的一个重要风险因素。
General population survey data are used to disaggregate the associations of substance use disorders with suicide attempts in order to evaluate a number of hypotheses about the processes leading to these associations. Data are from the US National Comorbidity Survey (1990-1992). Discrete-time survival analysis is used to study the effects of retrospectively reported temporally prior substance use, abuse, and dependence in predicting first onset of suicidal behavior. Alcohol and drug use predict subsequent suicide attempts after controlling for sociodemographics and comorbid mental disorders. Previous use is not a significant predictor among current nonusers. Abuse and dependence are significant predictors among users for three of the 10 substances considered (alcohol, inhalants, and heroin). The number of substances used is more important than the types of substances used in predicting suicidal behavior. Disaggregation shows that the effects of use are largely on suicidal ideation and nonplanned attempts among ideators. In comparison, the effects of use on suicide plans and planned attempts among ideators are not significant. Clinicians need to be aware that current substance use, even in the absence of abuse or dependence, is a significant risk factor for unplanned suicide attempts among ideators.