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Tự sát ở những người được điều trị rối loạn sử dụng chất: Nghiên cứu liên kết hồ sơ quốc gia Đan Mạch
Tóm tắt
Rối loạn sử dụng chất là một yếu tố nguy cơ chính dẫn đến tự sát. Tuy nhiên, các yếu tố nguy cơ cụ thể liên quan đến tự sát ở những người mắc rối loạn sử dụng chất vẫn chưa được nghiên cứu đầy đủ. Nghiên cứu đoàn hệ dân số này đã đánh giá tình trạng tự sát ở những người được điều trị rối loạn sử dụng thuốc tại Đan Mạch từ năm 2000 đến 2010 và mô tả các yếu tố nguy cơ của tự sát hoàn thành. Dữ liệu từ 27,942 cá nhân tham gia điều trị đã được liên kết với các cơ sở dữ liệu quốc gia và đối chiếu với các đối tượng không mắc rối loạn sử dụng chất (n = 138,136) và có (n = 1574) hoặc không có tiền sử tâm thần. Phân tích hồi quy rủi ro cạnh tranh đã được sử dụng để xác định các yếu tố nguy cơ của tự sát hoàn thành. Có 163 trường hợp tự sát ở những bệnh nhân có tiền sử điều trị ma túy (0.6% số bệnh nhân). Nguy cơ gia tăng được liên kết với độ tuổi trẻ hơn khi tham gia (tỷ lệ nguy cơ [HR] = 0.97, khoảng tin cậy 95% (CI): 0.95, 0.98), có tiền sử chăm sóc tâm thần (HR = 1.96, CI 95%: 1.39, 2.77), sử dụng opioid (HR = 1.81, 95% CI: 1.23, 2.68), và sử dụng rượu (HR = 1.56, 95% CI: 1.09, 2.23). Nguy cơ thấp hơn được liên kết với việc sử dụng cần sa (HR = 0.69, 95% CI: 0.50, 0.96). So với các đối chứng đồng tuổi và giới tính không có lịch sử điều trị rối loạn sử dụng chất hoặc chăm sóc tâm thần gần đây, tỷ lệ tử vong tiêu chuẩn do tự sát là 7.13 cho những người mắc rối loạn sử dụng thuốc không có lịch sử chăm sóc tâm thần (95% CI: 5.81, 8.44), 13.48 cho những người mắc rối loạn sử dụng thuốc và có tiền sử tâm thần (95% CI: 9.75, 17.22), và 13.61 cho những người chỉ có tiền sử tâm thần (95% CI: 6.72, 20.50). Nguy cơ tự sát gia tăng ở những người mắc rối loạn sử dụng thuốc. Việc tiếp cận điều trị cho các vấn đề sức khỏe tâm thần đi kèm ở những người mắc rối loạn sử dụng thuốc có thể làm giảm nguy cơ tự sát.
Từ khóa
#rối loạn sử dụng chất #tự sát #yếu tố nguy cơ #nghiên cứu đoàn hệ #Đan MạchTài liệu tham khảo
World Health Organization. Monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2018.
Naghavi M, Collab GBDS-H. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the global burden of disease study 2016. BMJ. 2019;364:194.
Breet E, Goldstone D, Bantjes J. Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review. BMC Public Health. 2018;18(1):549.
Poorolajal J, Haghtalab T, Farhadi M, Darvishi N. Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: a meta-analysis. J Public Health (Oxf). 2016;38(3):e282–e91.
Conner KR, Bridge JA, Davidson DJ, Pilcher C, Brent DA. Metaanalysis of mood and substance use disorders in proximal risk for suicide deaths. Suicide Life Threat Behav. 2019;49(1):278–92.
Borgschulte M, Corredor-Waldron A, Marshall G. A path out: prescription drug abuse, treatment, and suicide. J Econ Behav Organ. 2018;149:169–84.
Ashrafioun L, Bishop TM, Conner KR, Pigeon WR. Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts. J Psychiatr Res. 2017;92:1–7.
Halladay JE, Boyle MH, Munn C, Jack SM, Georgiades K. Sex differences in the association between Cannabis use and suicidal ideation and attempts, depression, and psychological distress among Canadians. Can J Psychiatry. 2018;64(5):345–50.
Halladay JE, Munn C, Boyle M, Jack SM, Georgiades K. Temporal changes in the cross-sectional associations between Cannabis use, suicidal ideation, and depression in a nationally representative sample of Canadian adults in 2012 compared to 2002. Can J Psychiatry. 2019:706743719854071.
Shalit N, Shoval G, Shlosberg D, Feingold D, Lev-Ran S. The association between cannabis use and suicidality among men and women: a population-based longitudinal study. J Affect Disord. 2016;205:216–24.
Beautrais AL, Joyce PR, Mulder RT. Cannabis abuse and serious suicide attempts. Addiction. 1999;94(8):1155–64.
Hawton K, van Heeringen K. Suicide. Lancet. 2009;373(9672):1372–81.
Chan MK, Bhatti H, Meader N, Stockton S, Evans J, O'Connor RC, et al. Predicting suicide following self-harm: systematic review of risk factors and risk scales. Br J Psychiatry. 2016;209(4):277–83.
Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, Harris MG, et al. The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010. PloS One. 2014;9(4):e91936.
Global Burden of Disease Study. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME); 2017.
Borges G, Bagge CL, Orozco R. A literature review and meta-analyses of cannabis use and suicidality. J Affect Disord. 2016;195:63–74.
Price C, Hemmingsson T, Lewis G, Zammit S, Allebeck P. Cannabis and suicide: longitudinal study. Br J Psychiatry. 2009;195(6):492–7.
Racine M. Chronic pain and suicide risk: a comprehensive review. Prog Neuro-Psychopharmacol Biol Psychiatry. 2018;87:269–80.
Holma KM, Haukka J, Suominen K, Valtonen HM, Mantere O, Melartin TK, et al. Differences in incidence of suicide attempts between bipolar I and II disorders and major depressive disorder. Bipolar Disord. 2014;16(6):652–61.
Angst F, Stassen HH, Clayton PJ, Angst J. Mortality of patients with mood disorders: follow-up over 34-38 years. J Affect Disorders. 2002;68(2–3):167–81.
Temes CM, Frankenburg FR, Fitzmaurice GM, Zanarini MC. Deaths by Suicide and Other Causes Among Patients With Borderline Personality Disorder and Personality-Disordered Comparison Subjects Over 24 Years of Prospective Follow-Up. J Clin Psychiatry. 2019;80(1). https://doi.org/10.4088/JCP.18m12436.
Thylstrup B, Bloomfield K, Hesse M. Incremental predictive validity of the addiction severity index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders. Addict Behav. 2018;76(1):201–7.
Pedersen CB. The Danish civil registration system. Scand J Public Health. 2011;39(7 Suppl):22–5.
Ministry of Children and Social Affairs. Bekendtgørelse om dataindberetninger på socialområdet [Executive Order on Data Reporting on Social Services]: retsinformation.dk; 2018 [Available from: https://doi.org/https://www.retsinformation.dk/pdfPrint.aspx?id=196791.
Schmidt M, Schmidt SAJ, Sandegaard JL, Ehrenstein V, Pedersen L, Sørensen HT. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol. 2015;7:449–90.
Mors O, Perto GP, Mortensen PB. The Danish psychiatric central research register. Scand J Public Health. 2011;39:54–7.
Helweg-Larsen K. The Danish register of causes of death. Scand J Public Health. 2011;39:26–9.
Lund J. Mentally retarded criminal offenders in Denmark. Br J Psychiatry. 1990;156:726–31.
WHO. ICD-10 : international statistical classification of diseases and related health problems / World Health Organization. Geneva: World Health Organization; 2004.
Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94(446):496–509.
StataCorp. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. 2017.
Gjertsen F, Bruzzone S, Griffiths CE. Burden of suicide presented as one of the leading causes of death: uncover facts or misrepresent statistics? J Glob Health. 2019;9(1):010401.
Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM. Psychological autopsy studies of suicide: a systematic review. Psychol Med. 2003;33(3):395–405.
Ilgen MA, Bohnert AS, Ganoczy D, Bair MJ, McCarthy JF, Blow FC. Opioid dose and risk of suicide. Pain. 2016;157(5):1079–84.
Austin AE, Proescholdbell SK, Creppage KE, Asbun A. Characteristics of self-inflicted drug overdose deaths in North Carolina. Drug Alcohol Depend. 2017;181:44–9.
Samples H, Stuart EA, Olfson M. Opioid use and misuse and suicidal behaviors in a nationally representative sample of US adults. Am J Epidemiol. 2019;188(7):1245–53.
Schneider B. Substance use disorders and risk for completed suicide. Arch Suicide Res. 2009;13(4):303–16.
Pfeifer P, Bartsch C, Hemmer A, Reisch T. Acute and chronic alcohol use correlated with methods of suicide in a Swiss national sample. Drug Alcohol Depend. 2017;178:75–9.
Kolves K, Draper BM, Snowdon J, De Leo D. Alcohol-use disorders and suicide: results from a psychological autopsy study in Australia. Alcohol. 2017;64:29–35.
Park CHK, Yoo SH, Lee J, Cho SJ, Shin MS, Kim EY, et al. Impact of acute alcohol consumption on lethality of suicide methods. Compr Psychiatry. 2017;75:27–34.
van Ours JC, Williams J, Fergusson D, Horwood LJ. Cannabis use and suicidal ideation. J Health Econ. 2013;32(3):524–37.
Borges G, Benjet C, Orozco R, Medina-Mora M-E, Menendez D. Alcohol, cannabis and other drugs and subsequent suicide ideation and attempt among young Mexicans. J Psychiatr Res. 2017;91:74–82.
Hurd YL, Yoon M, Manini AF, Hernandez S, Olmedo R, Ostman M, et al. Early phase in the development of Cannabidiol as a treatment for addiction: opioid relapse takes initial center stage. Neurotherapeutics. 2015;12(4):807–15.
Lac A, Luk JW. Testing the Amotivational syndrome: marijuana use longitudinally predicts lower self-efficacy even after controlling for demographics, personality, and alcohol and cigarette use. Prev Sci. 2018;19(2):117–26.
Hesse M. Integrated psychological treatment for substance use and co-morbid anxiety or depression vs. treatment for substance use alone. A systematic review of the published literature. BMC Psychiatry. 2009:9.
Delgadillo J, Gore S, Ali S, Ekers D, Gilbody S, Gilchrist G, et al. Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment. J Subst Abus Treat. 2015;55:6–14.
Watkins KE, Hunter SB, Hepner KA, Paddock SM, de la Cruz E, Zhou AJ, et al. An effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment. Arch Gen Psychiat. 2011;68(6):577–84.
Baker AL, Kavanagh DJ, Kay-Lambkin FJ, Hunt SA, Lewin TJ, Carr VJ, et al. Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: outcomes to 36-months. J Subst Abus Treat. 2014;46(3):281–90.
Assefa MT, Ford JH, Osborne E, McIlvaine A, King A, Campbell K, et al. Implementing integrated services in routine behavioral health care: primary outcomes from a cluster randomized controlled trial. BMC Health Serv Res. 2019;19(1):749.
Nunes EV, Levin FR. Treatment of depression in patients with alcohol or other drug dependence - a meta-analysis. JAMA. 2004;291(15):1887–96.
Hesse M. Achieving abstinence by treating depression in the presence of substance-use disorders. Addict Behav. 2004;29(6):1137–41.
Agabio R, Trogu E, Pani PP. Antidepressants for the treatment of people with co-occurring depression and alcohol dependence. Cochrane Database Syst Rev. 2018;4:CD008581.
Kandel DB, Hu MC, Griesler P, Wall M. Increases from 2002 to 2015 in prescription opioid overdose deaths in combination with other substances. Drug Alcohol Depend. 2017;178:501–11.
Turner BJ, Liang YY. Drug overdose in a retrospective cohort with non-cancer pain treated with opioids, antidepressants, and/or sedative-hypnotics: interactions with mental health disorders. J Gen Intern Med. 2015;30(8):1081–96.
Delgadillo J, Bohnke JR, Hughes E, Gilbody S. Disentangling psychopathology, substance use and dependence: a factor analysis. BMC Psychiatry. 2016;16:281.
Hesse M, Guldager S, Linneberg IH. Convergent validity of MCMI-III clinical syndrome scales. Brit J Clin Psychol. 2012;51:172–84.
Thylstrup B, Bloomfield K, Hesse M. Incremental predictive validity of the addiction severity index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders. Addict Behav. 2018;76:201–7.
Rockett IRH, Caine ED, Connery HS, D'Onofrio G, Gunnell DJ, Miller TR, et al. Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history. PloS One. 2018;13(1):e0190200.
Tollefsen IM, Hem E, Ekeberg O. The reliability of suicide statistics: a systematic review. BMC Psychiatry. 2012;12:9.