Drug Abuse, Psychological Variables and Suicide Attempts

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DESCRIPTION (provided by applicant): The purpose of the present study is to use an existing database to examine prospectively the relationship among drug abuse, clinical and psychological variables, and repeated suicide attempts. The database for this study includes 151 patients, 91 (60%) of whom were drug abusers, who were evaluated at the emergency department of a large urban hospital following a recent suicide attempt and who were evaluated subsequently at specific intervals for at least a one-year period. Specifically, we plan (a) to test whether the hazard rate for a repeat suicide attempt during a 3 year follow-up period will be significantly higher for patients with a Drug Use Disorder (DUD) than the hazard rate for patients without a Drug Use Disorder; and (b) to explore whether there is an additive or interactive relationship between depression,hopelessness, and suicidal ideation and a DUD diagnosis or current illicit drug use in predicting subsequent suicide attempts. Survival analysis, using both parametric and nonparametric models, will be the primary analytic strategy to examine the relationship among drug abuse and clinical and psychological variables, as time-varying covariates, and suicide attempts. In addition to these analyses, detailed clinical narratives of approximately 300 suicide attempts will be systematically analyzed to develop a psychological model that describes the patterns that typically precede a suicide attempt. This pattern analysis will then be used in conjunction with the survival analyses to develop mixed models that provide a clearer picture of the complex relationships among drug use, relevant psychological variables and repeat suicide attempts.