Triggers for suicidal behavior in depressed older adolescents and young adults: Do alcohol use disorders make a difference?

Abstract

Adolescent suicide is a major social and medical problem. Alcohol use disorders with comorbid major depression represent an especially high-risk profile for suicidal behavior, repeated suicidal behavior and completed suicide. We compared demographic and clinical characteristics, prevalence of interpersonal triggers and the number of triggers for suicidal behavior in depressed late adolescents and young adults with or without comorbid alcohol use disorders. Methods. 18-26-yearold subjects were recruited through advertising and referrals and participated in mood disorders research in a university hospital. Thirty-eight depressed suicide attempters without a history of any alcohol or substance abuse/dependence and 29 depressed suicide attempters with comorbid alcohol abuse or dependence participated in the study. Demographic and clinical parameters including parameters related to suicidal behavior were examined and recorded. Results. There was no difference with regard to demographic parameters between the two groups. Depressed suicide attempters with comorbid alcohol use disorders had higher aggression and impulsivity scale scores and were more likely to be tobacco smokers compared to their counterparts without alcohol use disorders. Additionally, there was a trend towards higher lethality of suicide attempts in subjects with alcohol use disorders compared to the other group. We found no difference in the prevalence of interpersonal triggers or in the number of triggers for suicidal behavior between the two groups.Conclusion. It appears that among 18-26-year-old depressed suicide attempters, individuals with comorbid alcohol use disorders are more impaired with regard to aggressiveness and impulsivity compared to persons without comorbid alcohol abuse/dependence.

Developing an integrated treatment for substance use and depression using cognitive–behavioral therapy

“…Compared to patients with depression, alcoholism, or drug dependence alone, those with co-occurring disorders (COD) experience greater risk of more serious substance use (Conway, Compton, Stinson, & Grant, 2006) and higher rates of both attempted and completed suicide (Aharonovich, Liu, Nunes, & Hasin, 2002; Cornelius et al, 1995; Kingree, Thompson, & Kaslow, 1999; Lynskey et al, 2004; Sher et al, 2007). Among those who seek treatment, individuals with COD also experience poorer mental health and SUD treatment outcomes (Bagby, Ryder, & Cristi, 2002; Brown et al, 1998; Hasin et al, 2002; Melartin et al, 2004; Watkins, Paddock, Zhang, & Wells, 2006) and higher treatment costs than persons who have only one disorder (Dickey & Azeni, 1996; Hoff & Rosenheck, 1998).…”

Depression symptoms as a mediator between social support, non-suicidal self-injury, and suicidal ideation among Arab adolescents in Israel

“…In addition to the severe physical, mental and interpersonal consequences, NSSI is associated with an elevated risk for suicidal behaviors (Hamza et al., 2012; Plemmons et al., 2018). Various individual characteristics and emotional states have been established as key factors in NSSI, such as emotion regulation strategies (NSSI is negatively related to reappraisal of the situation or problem-oriented approach, and positively related with rumination or emotional suppression; Hasking et al., 2017; Wolff et al., 2019), depression symptoms (Heath et al., 2016; Tuisku et al., 2014), diagnosis of other psychopathologies such as obsessive-compulsive disorder (Albert et al., 2019; Shoval et al., 2006) or alcohol use disorder (Borges et al., 2017; Sher et al., 2007), parental support (i.e., parents’ supportive practices such as expression of positive affection, allowing autonomous choices, and providing help when needed are negatively associated with NSSI; Arbuthnott & Lewis, 2015; Bureau et al., 2010), and childhood abuse or other aversive experiences (Martin et al., 2016).…”

From Childhood Maltreatment to Depression Behind Bars : Testing a Theoretical Model of Adolescent Depression Among Juvenile Offenders

“…Increased impulsivity has been identified as a causal factor in the escalation of substance use as well as the acquisition of substance use disorders (Perry & Carroll, 2008). Alternatively, impulsivity has been identified as a consequence of prolonged substance use (Sher et al, 2007). However, Conrod, Pihl, Stewart, and Dongier (2000) advocated for the notion that impulsivity is present before substance use.…”