Suicidal ideation and HIV risk behaviors among a cohort of injecting drug users in New Delhi, India
Tóm tắt
Data on mental health among injecting drug users in South Asia is scarce yet poor mental health among users has significant implications for the success of HIV prevention and treatment programmes. A cohort of 449 injecting drug users in Delhi was examined on the following issues (1) examine trends in suicidal ideation, suicide plan and suicidal attempts over a 12-month period, (2) examine association between injecting practices (receive and give used syringes) and suicidal ideation over a 12 month study period. An observational study was conducted providing phased interventions with follow up interviews every 3 months to 449 injecting drug users (IDUs), from August 2004 to November 2005. The study was conducted in Yamuna Bazaar, a known hub of drug peddling in Delhi. Interventions included nutrition, basic medical services, needle exchange, health education, HIV voluntary counseling and testing, STI diagnosis and treatment, oral buprenorphine substitution, and detoxification, each introduced sequentially. Suicidal ideation and suicide attempts, did not significantly change over 12 months of observation, while suicide plans actually increased over the time period. Keeping other factors constant, IDUs with suicidal ideation reported more giving and receiving of used syringes in the recent past. Conclusions: Mental health services are warranted within harm reduction programmes. Special attention must be paid to suicidal IDUs given their higher risk behaviours for acquiring HIV and other blood borne infections. IDU intervention programmes should assess and address suicide risk through brief screening and enhanced counseling.
Tài liệu tham khảo
Corty E, Ball JC: Psychological symptoms in methadone maintenance patients: prevalence and change over treatment. J Consult Clin Psychol. 1988, 56 (5): 776-777.
Kaplan CD, Wauters L, Limbeek JV: Prevalence of psychopathology among drug addicted Dutch. J Subst Abuse Treatment. 1992, 9: 43-52. 10.1016/0740-5472(92)90009-D.
Luthar SS, Cushing G: Gender differences among opioid abusers: pathways to disorder and profiles of psychopathology. Drug Alcohol Depend. 1996, 43 (3): 179-189. 10.1016/S0376-8716(96)01310-5.
Borges G, Walters EE: Associations of substance use, abuse, and dependence with subsequent suicidal behavior. Am J Epidemiol. 2000, 151 (8): 781-789. 10.1093/oxfordjournals.aje.a010278.
Darke S, Ross J: Suicide among heroin users: rates, risk factors and methods. Addiction. 2002, 97 (11): 1383-1394. 10.1046/j.1360-0443.2002.00214.x.
Dinwiddie SH, Reich T: Psychiatric comorbidity and suicidality among intravenous drug users. J Clin Psychiatry. 1992, 53 (10): 364-369.
Harris EC, Barraclough B: Suicide as an outcome of mental disorder. A meta analysis. British J Psychiatry. 1997, 170: 208-228.
O'Driscoll PT, McGough J: Predictors of accidental fatal drug overdose among a cohort of injection drug users. Am J Public Health. 2001, 91 (6): 984-987.
Miller C, Kerr T, Strathdee SA, Lee K, Wood E: Factors associated with premature mortality among young injection drug users in Vancouver. Harm Reduction J. 2007, 4 (4): 1-
Kosten TR, Rounsaville BJ: Suicidality among opioid addicts: 2.5 year follow-up. Am J Drug Alcohol Abuse. 1988, 14 (3): 357-369. 10.3109/00952998809001557.
Cottler LB, Campbell W, Krishna VA, Cunningham-Williams RM, Abdallah AB: Predictors of high rates of suicidal ideation among drug users. J Nerv Ment Dis. 2005, 193 (7): 431-437. 10.1097/01.nmd.0000168245.56563.90.
Darke S, Kaye S: Attempted suicide among injecting and noninjecting cocaine users in Sydney, Australia. J Urban Health. 2004, 81 (3): 505-515. 10.1093/jurban/jth134.
Havens JR, Strathdee SA, Fuller CM, Ikeda R, Friedman SR, Des Jarlais DC, Morse PS, Bailey S, Kerndt P, Garfein RS: Collaborative Injection Drug User Study Group.(2004). Correlates of attempted suicide among young injection drug users in a multi site cohort. Drug Alcohol Depend. 2004, 6:75 (3): 261-269.
Chatham LR, Knight K: Suicidality in a sample of methadone maintenance clients. Am J Drug Alcohol Abuse. 1995, 21 (3): 345-361. 10.3109/00952999509002702.
Broers B, Bousquest A, Mino A: Substance abuse and drug related death, suicidal ideation, and suicide: a review. Crisis. 1999, 20 (1): 28-35.
Mojtabai R, Olfson M: Perceived Need and Help-Seeking in Adults With Mood, Anxiety, or Substance Use Disorders. Arch Gen Psychiatry. 2002, 59 (1): 77-84. 10.1001/archpsyc.59.1.77.
Aaron R, Joseph A: Suicides in young people in rural southern India. Lancet. 2004, 363 (9415): 1117-1118. 10.1016/S0140-6736(04)15896-0.
Abraham VJ, Abraham S, Jacob KS: Suicide in the elderly in Kanyambadi block, Tamil Nadu, India. Int J Geriatr Psychiatry. 2005, 20 (10): 953-955. 10.1002/gps.1385.
Jacob KS: The prevention of suicide in India and the developing world, the need for population based strategies. Crisis. 2008, 29 (2): 102-106.
Rounsaville BJ, Tierney T: Predictors of outcome in treatment of opiate addicts: evidence for the multidimensional nature of addicts' problems. Compr Psychiatry. 1982, 23 (5): 462-478. 10.1016/0010-440X(82)90160-2.
Marlatt GA, Gordon : Relapse prevention. 1985, New York: Guilford press
Havard A, Teesson M: Depression among heroin users: 12-Month outcomes from the Australian Treatment Outcome Study (ATOS). J Subst Abuse Treat. 2006, 30 (4): 355-362. 10.1016/j.jsat.2006.03.012.
Teesson M, Mills K, Ross J, Darke S, Williamson A, Havard A: The impact of treatment on 3years' outcome for heroin dependence: findings from the Australian Treatment Outcome Study (ATOS). Addiction. 2008, 103 (1): 80-88. 10.1111/j.1360-0443.2007.02029.x.
Perdue T, Hagan H: Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men. AIDS Educ Prev. 2003, 15 (1): 81-92. 10.1521/aeap.15.1.81.23842.
Camacho LM, Brown BS: Psychological dysfunction and HIV/AIDS risk behavior. J Acquir Immune Defic Syndr Hum Retrovirol. 1996, 11 (2): 198-202. 10.1097/00042560-199602010-00012.
Mandell W, Kim J: Depressive symptoms, drug network, and their synergistic effect on needle-sharing behavior among street injection drug users. Am J Drug Alcohol Abuse. 1999, 25 (1): 117-127. 10.1081/ADA-100101849.
Johnson ME, Yep MJ: Relationship among gender, depression, and needle sharing in a sample of injection drug users. Psychol Addict Behav. 2002, 16 (4): 338-341.
O’Caroll PW, Berman AL, Maris RW, Moscicki EK, Tanney BL, Silverman MM: Beyond the tower of Babel: a nomenclature for suicidology. Suicide life threat. Behav. 1996, 26: 237-252.
Lee JH, Herzog TA, Meade CD, Webb MS, Brandon TH: The use of GEE for analyzing longitudinal binomial data: a primer using data from a tobacco intervention. Addict Behav. 2007, 32 (1): 187-193. 10.1016/j.addbeh.2006.03.030. Epub 2006 May 2
Dorabjee J, Sarin E, Singh S, Deepak V, Mishra M: Rapid situation assessment of drug use in Delhi. 2000, Sharan, New Delhi: Report submitted to the European Commission, 110016-
Prasad J, Abraham VJ, Minz S, Abraham S: Rates and factors associated with suicide in Kamijama bedi block, Tamil nadu and South India, 2000–2002. Ind J Soc Psychiatry. 2006, 52: 65-71. 10.1177/0020764006061253.
Vijaykumar L, John S, Pirkis J, Whiteford H: Suicide in developing countries: risk factors. Crisis. 2005, 26: 112-119.
Gururaj G, Isaac MK, Subbakrishna DK, Ranjani R: Risk factors for completed suicides: A case–control study from Bangalore, India. Inj Control Saf Promot. 2004, 11: 183-189. 10.1080/156609704/233/289706.
Rohde P, Noell J: Depression, suicidal ideation and STD-related risk in homeless older adolescents. J Adolesc. 2001, 24 (4): 447-460. 10.1006/jado.2001.0382.
Latkin CA, Mandell W: Depression as an antecedent of frequency of intravenous drug use in an urban, nontreatment sample. Int J Addict. 1993, 28 (14): 1601-1612.