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Acute Substance Use as a Warning Sign for Suicide Attempts: A Case-Crossover Examination of the 48 Hours Prior to a Recent Suicide Attempt.

Abstract The extent to which specific categories of acute substance use are short-term risk factors, or warning signs, for suicide attempts is unknown. The aim of the current study was to quantify the near-term effects of sole use and co-use of substances on medically attended suicide attempts.
PMID
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Acute Substance Use as a Warning Sign for Suicide Attempts: A Case-Crossover Examination of the 48 Hours Prior to a Recent Suicide Attempt.

Authors

Mayor MeshTerms
Keywords
Journal Title the journal of clinical psychiatry
Publication Year Start




PMID- 28682530
OWN - NLM
STAT- MEDLINE
DA  - 20170706
DCOM- 20170719
LR  - 20170719
IS  - 1555-2101 (Electronic)
IS  - 0160-6689 (Linking)
VI  - 78
IP  - 6
DP  - 2017 Jun
TI  - Acute Substance Use as a Warning Sign for Suicide Attempts: A Case-Crossover
      Examination of the 48 Hours Prior to a Recent Suicide Attempt.
PG  - 691-696
LID - 10.4088/JCP.15m10541 [doi]
LID - 15m10541 [pii]
AB  - OBJECTIVE: The extent to which specific categories of acute substance use are
      short-term risk factors, or warning signs, for suicide attempts is unknown. The
      aim of the current study was to quantify the near-term effects of sole use and
      co-use of substances on medically attended suicide attempts. METHODS: The current
      study used a case-crossover design, comparing substance use within the 24 hours
      prior to a suicide attempt (case day) to the control day, the matched 24 hours
      the day prior to the case day. Participants were 363 recent suicide attempters
      presenting to a Level 1 trauma hospital between October 2008 and April 2014. A
      timeline follow-back methodology was used to assess acute exposures within the 48
      hours before the suicide attempt. Conditional logistic regression was used to
      report odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Results
      indicated that patients were at increased odds of attempting suicide after
      drinking alcohol within a 24-hour period (OR = 4.40; 95% CI, 2.31-8.40) and using
      a drug from another class of substances with central nervous system (CNS)
      depressant characteristics (sedatives/anxiolytics and opioids; OR = 2.82; 95% CI,
      1.13-7.01), after adjustment for other acute substance use. The acute use of
      cannabis and CNS stimulants (stimulants/amphetamines and cocaine) was not
      uniquely associated with suicide attempt. Co-use of alcohol synergized effects of
      other CNS depressants (OR = 8.76; 95% CI, 1.02-75.44). CONCLUSIONS: Findings
      suggest the importance of considering acute alcohol use and use of CNS
      depressants, and the concurrent use of both substances, when evaluating
      short-term risk for suicide attempts in clinical settings.
FAU - Bagge, Courtney L
AU  - Bagge CL
AD  - University of Mississippi Medical Center, Department of Psychiatry and Human
      Behavior, 2500 N State St, Jackson, MS 39216. [email protected]
AD  - Department of Psychiatry and Human Behavior, University of Mississippi Medical
      Center, Jackson, Mississippi, USA.
FAU - Borges, Guilherme
AU  - Borges G
AD  - Department of Intervention Research, National Institute of Psychiatry, Mexico
      City, Mexico.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Central Nervous System Depressants)
RN  - 0 (Central Nervous System Stimulants)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Alcohol Drinking/*adverse effects
MH  - Alcoholic Intoxication/*complications
MH  - Central Nervous System Depressants/*adverse effects
MH  - Central Nervous System Stimulants/adverse effects
MH  - Cross-Over Studies
MH  - Drug Interactions
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Suicide, Attempted/*statistics & numerical data
MH  - Time Factors
MH  - Trauma Centers/statistics & numerical data
MH  - Young Adult
EDAT- 2017/07/07 06:00
MHDA- 2017/07/20 06:00
CRDT- 2017/07/07 06:00
PHST- 2015/11/19 [received]
PHST- 2016/03/24 [accepted]
AID - 10.4088/JCP.15m10541 [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2017 Jun;78(6):691-696. doi: 10.4088/JCP.15m10541.