Addiction and suicidal behavior in acute psychiatric inpatients

Ries, Richard K.; Yuodelis‐Flores, Christine; Roy‐Byrne, Peter; Nilssen, Odd; Russo, Joan

doi:10.1016/j.comppsych.2008.07.003

Cited by 25 publications

(20 citation statements)

References 27 publications

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“…For instance, individuals making suicide attempts in the context of acute alcohol use are more likely to receive emergency department treatment only and less likely to receive a referral to a psychiatrist (or psychiatric hospital) and to have arranged aftercare post-discharge for them (e.g., Suokas & Lönnqvist, 1995;Suominen & Lönnqvist, 2006). Data also suggest that patients hospitalized for suicide risk who are judged to have risk related to alcohol (or other drug) intoxication are discharged sooner than patients who are perceived not to have substance-related risk (Ries et al, 2009). The use of less intensive care with individuals who make suicide attempts in the context of acute alcohol use may be attributable to the widely held clinical belief that such attempts are characterized by a period of short proximal suicide premeditation and have low intent to die: factors used in weighing the severity of suicide attempts and risk for eventual suicide.…”

mentioning

confidence: 65%

Alcohol Use to Facilitate a Suicide Attempt: An Event-Based Examination

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Conner

Reed

et al. 2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The current study is based on the hypothesis that alcohol-involved suicide attempts are characterized by lower premeditation and intent, but only when the use of alcohol is not motivated by the desire to facilitate the attempt. Test of this idea was conducted by comparing proximal suicide premeditation and intent of suicide attempts among three groups: individuals who (a) drank to facilitate the attempt (e.g., to "numb fears" about attempting), (b) drank for nonfacilitative motives, and (c) did not use alcohol before the attempt. Method: Participants included 324 (62% female) recent suicide attempters presenting to a Level 1 trauma hospital. The Timeline Followback Interview for Suicide Attempts and a novel Suicide Facilitative Drinking Motives Scale were used to assess facilitative motives for drinking and characteristics of the attempt. Results: One third of participants drank before the attempt, and most (73%) who used alcohol did not do so to facilitate the attempt. As hypothesized, attempts carried out by this group had shorter proximal suicide premeditation and lower suicide intent compared with the other study groups; in contrast, individuals who drank to facilitate the attempt were similar to non-alcohol users on these indices. Conclusions: Alcohol-involved suicide attempts are heterogeneous. Motives for drinking are a key source of heterogeneity insofar as fundamental characteristics of attempts (proximal premeditation, intent) differ as a function of drinking motivation. Clinical implications include that individuals making suicide attempts with facilitative motives for drinking cannot be assumed to be at lowered risk upon a drop in blood alcohol level. (J. Stud. Alcohol Drugs, 76, 474-481, 2015)

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mentioning

confidence: 65%

Alcohol Use to Facilitate a Suicide Attempt: An Event-Based Examination

Bagge

Conner

Reed

et al. 2015

J. Stud. Alcohol Drugs

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“…Little is known, however, about the sociodemographic and clinical associations of toxicological findings among patients admitted to acute psychiatric wards. Our findings suggest that acutely admitted patients with both substance use and suicidal behaviour require specialized focus (121). The short hospital stays for substance users comprise a major challenge for proper assessment and treatment, and underline the importance of the initial assessments and the potential for toxicological analyses.…”

Section: Recent Alcohol Intake Was Associated With Suicidal Behaviourmentioning

confidence: 99%

“…Clinical assessment of recent drug intake is a challenging task, and when compared with laboratory drug findings, these studies report significant discrepancies. In a few studies, physicians have assessed whether the acute psychiatric admission was related to substance use (119) or substance induced (120,121).…”

Section: Physician Assessmentmentioning

confidence: 99%

“…The review was performed by the first author for all patients at Lovisenberg and by research assistants in Arendal. Most variables were gathered and coded with similar methods as in the national survey performed in 2005 (16), including the Global assessment of functioning and symptoms (GAF, split version) (164,165) and an assessment of suicidal risk at admission by rating patients on a scale from 1 to 6, where 1 = 'no risk' and 6 = 'recent severe self-harm with obvious intention to die' (121). The researchers also obtained additional information about prescribed medication before and during hospitalization.…”

Section: Review Of Medical Records and Clinical Diagnosesmentioning

confidence: 99%

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Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Mordal

Bramness

Holm

et al. 2008

General Hospital Psychiatry

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“…Clinicians believe that AUS related self-harm is linked to lower levels of premeditation (i.e., is more impulsive) and lower levels of suicidal intent [15]. This belief together with aggressive or uncontrolled behaviour upon arrival at the emergency department, seems to lead to self-harm patients who had been using substances receiving less intensive medical care and being discharged sooner than patients who did not have a substance-related risk for suicidal behaviour [17]. …”

Section: Introductionmentioning

confidence: 99%

Substance use and self-harm: a cross-sectional study of the prevalence, correlates and patterns of medical service utilisation among patients admitted to a South African hospital

Breet

Bantjes

Lewis

2018

BMC Health Serv Res

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BackgroundSubstance use is a potentially modifiable risk factor for suicidal behaviour. Little is known about the epidemiology of substance use among self-harm patients in South Africa. This study set out to collect epidemiological data about the prevalence, correlates, and patterns of medical service utilisation among self-harm patients who used substances at the time of self-injury.MethodsData from 238 consecutive self-harm patients treated at an urban hospital in South Africa were analysed using bivariate and multivariate statistics.ResultsApproximately 20% of patients reported substance use at the time of self-harm. When compared to other self-harm patients, higher rates of patients who had used substances: had depressed levels of consciousness on admission; utilised more medical resources and required longer hospital admissions; cited relationship difficulties and financial concerns as reasons for their self-harm; reported a previous episode of self-harm; and intended to die as a result of their injuries. Although the observed differences were not statistically significant (p > 0.05), the proportional differences were congruent with international literature.ConclusionAcute use of substances among self-harm patients warrants more focused research and clinical attention particularly in the context of reducing utilisation of scarce medical resources.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-2963-7) contains supplementary material, which is available to authorized users.

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Addiction and suicidal behavior in acute psychiatric inpatients

Cited by 25 publications

References 27 publications

Alcohol Use to Facilitate a Suicide Attempt: An Event-Based Examination

Alcohol Use to Facilitate a Suicide Attempt: An Event-Based Examination

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Substance use and self-harm: a cross-sectional study of the prevalence, correlates and patterns of medical service utilisation among patients admitted to a South African hospital

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