Abstract

We assessed the prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among patients with substance use disorders (SUD). Studies in English published from January 1, 1995 to December 31, 2020 were searched on PubMed, Scopus, Cochrane and Web of Science to identify studies on variables associated with suicidal behaviors (ideations and attempts) among patients with SUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria: (i) population: patients with SUD; (ii) intervention: suicide behaviors in the past year; (iii) comparator: SUD who had not suicide behaviors; (iv) outcome: suicide ideations or attempts in the last year; and (v) study type: cross-sectional, cohort, and case–control studies. Out of 10,810 articles, 48 studies met eligibility criteria. Our findings showed a pooled prevalence rate of suicide ideations of 35% (95% CI, 22% 48%) and suicide attempts of 20% (95% CI, 17% 23%) in the last year among patients with SUD. Smoking, previous history of sexual abuse, depression, and alcohol and cannabis use disorders were significantly associated with suicide ideations. Study findings also showed that being female, smoking, history of physical and sexual abuse, depression and alcohol, cannabis, cocaine, amphetamine use disorders, and polysubstance abuse were significantly associated with suicide attempts among patients with SUD. These findings have implications for developing prevention programs. Appropriate initiatives for reducing the risk of suicide behaviors like systematic assessments of changes in drug use pattern at the emergency departments or at other key health providers may be more broadly implemented. Motivational therapy to improve help-seeking, increased information on adverse consequences of heavy substance use, and crisis plan resolutions to face suicide behaviors could also be consolidated.

摘要

我们评估了物质使用障碍 (SUD) 患者的患病率、社会人口学变量、心理健康状况和与自杀行为相关的药物使用类型。在 PubMed、Scopus、Cochrane 和 Web of Science 上检索了 1995 年 1 月 1 日至 2020 年 12 月 31 日发表的英文研究，以确定与 SUD 患者的自杀行为（想法和企图）相关的变量的研究。在审查研究重复后，使用人群、干预、比较、结果 (PICO) 标准对所选文章的全文进行资格评估：(i) 人群：SUD 患者；(ii) 干预：过去一年的自杀行为；(iii) 比较对象：没有自杀行为的SUD；(iv) 结果：去年的自杀意念或企图；(v) 研究类型：横断面、队列、和病例对照研究。在 10,810 篇文章中，48 项研究符合资格标准。我们的研究结果显示，去年 SUD 患者的自杀意念汇总率为 35%（95% CI，22% 48%），自杀未遂率为 20%（95% CI，17% 23%）。吸烟、性虐待史、抑郁症、酒精和大麻使用障碍与自杀意念显着相关。研究结果还表明，女性、吸烟、身体和性虐待史、抑郁和酒精、大麻、可卡因、苯丙胺使用障碍和多物质滥用与 SUD 患者的自杀企图显着相关。这些发现对制定预防计划具有重要意义。可以更广泛地实施降低自杀行为风险的适当举措，例如系统评估急诊科或其他主要卫生提供者的吸毒模式变化。也可以巩固改善寻求帮助的动机疗法、增加有关大量使用药物的不良后果的信息以及应对自杀行为的危机计划解决方案。