Suicide Attempts Associated to Substance Use Disorders; A Descriptive Study

INTRODUCTION:In order to support service planning of the youth program of the East of Montreal Health and Social Services Board, and potentially of the other twenty-five programs across the Quebec province, our hospital-based Health Technology Assessment (HTA) unit was asked to bring evidence of the effective interventions for five most common mental disorders in children and young populations, namely anxio-depressive disorders, attention deficit and hyperactivity disorder, oppositional and conduct disorders, substance abuse disorders, and suicide attempts.METHODS:A review of reviews was conducted for the five disorders in young populations aged 6 to 25 years. This was based exclusively on systematic reviews and meta-analysis of a minimum two randomized-controlled trials. The review was completed with examples of Quebec's good practices in youth mental health gathered from personal research experience of clinical researchers involved in the project. The project involved collaboration with three other hospital units and provincial HTA agencies.RESULTS:No review supporting screening and early detection for the five disorders was identified. Prevention, however, was better covered in the literature, and a clear distinction was made between universal, targeted and indicated interventions. In general, targeted and indicated prevention interventions were effective in the case of anxio-depressive (1) and substance use disorders, while universal prevention strategies seemed to reduce suicide attempts and suicide ideation (2). Effective treatments also exist for these mental disorders. In general, psychotherapies dominated for anxio-depressive and substance use disorders; parental skills dominated in oppositional disorders, whilst pharmacological treatment dominated in attention deficit and hyperactivity disorder (3). Evidence was limited for suicide attempts. The overview of Quebec's good practices allowed identification of interventions or practices already in use in the province.CONCLUSIONS:The review summarized effective interventions for five most common mental disorders in young populations. It also permitted to identify several research gaps, and therefore research recommendations were formulated for the province's health research agency.

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Over-the-Counter Drugs and Other Substances Used in Attempted Suicide Presented to Emergency Departments in Montreal, Canada

Crisis ◽

10.1027/0227-5910/a000545 ◽

2019 ◽

Vol 40 (3) ◽

pp. 166-175 ◽

Cited By ~ 1

Author(s):

Alexandre Mikhail ◽

Omaid Tanoli ◽

Gilles Légaré ◽

Pierre-André Dubé ◽

Youssef Habel ◽

...

Keyword(s):

Substance Use ◽

Suicide Attempt ◽

Substance Use Disorders ◽

Prescription Drugs ◽

Suicide Attempts ◽

Patient Characteristics ◽

Cross Sectional ◽

Over The Counter ◽

Otc Drugs ◽

Do So

Abstract. Background: Over-the-counter (OTC) analgesics are frequently used in suicide attempts. Accessibility, toxicity, and unsupervised acquisition of large amounts may be facilitators. Aims: To identify patient characteristics associated with OTC drug use as a suicide attempt method among adults. Method: A cross-sectional study was conducted using chart review of all individuals who presented to the emergency department (ED) of two adult general hospitals following a suicide attempt during 2009–2010 in Montreal, Canada. Results: Among the 369 suicide attempters identified, 181 used overdosing, 47% of whom used OTC drugs. In logistic regression, women and those with medical comorbidity were more likely to use overdosing, while those with substance use disorders were less likely to do so. Among those who overdosed, women were more likely to use OTC drugs, while those who were Caucasian, had children, comorbidities, diagnoses with substance use disorders, and made attempts in the Fall were less likely to do so. Substances most frequently used were: acetaminophen among OTC drugs (30%); antidepressants (37%), anxiolytics (30%), opioids (10%), and anticonvulsants (9%) among prescription drugs; and cocaine (10%) among recreational drugs. Limitations: Reasons for the suicide method choice were not available. Conclusion: OTC drugs, in particular acetaminophen, are frequently used in suicide attempts. Accessibility to these drugs may be an important contributor.

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Substance use disorders and suicide attempts in bipolar subtypes

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2008.05.001 ◽

2009 ◽

Vol 43 (3) ◽

pp. 230-238 ◽

Cited By ~ 62

Author(s):

M. Elizabeth Sublette ◽

Juan J. Carballo ◽

Carmen Moreno ◽

Hanga C. Galfalvy ◽

David A. Brent ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Suicide Attempts

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A Retrospective Descriptive Study of Nurses With Substance Use Disorders in Texas

Journal of Addictions Nursing ◽

10.1097/jan.0000000000000273 ◽

2019 ◽

Vol 30 (2) ◽

pp. 78-86 ◽

Cited By ~ 1

Author(s):

Mercy N. Mumba ◽

Susan M. Baxley ◽

Diane E. Snow ◽

Daisha J. Cipher

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Descriptive Study

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Serious suicide attempts in outpatients with multiple substance use disorders

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2017.08.037 ◽

2017 ◽

Vol 181 ◽

pp. 63-70 ◽

Cited By ~ 11

Author(s):

R. Icick ◽

E. Karsinti ◽

J-P. Lépine ◽

V. Bloch ◽

G. Brousse ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Suicide Attempts ◽

Multiple Substance

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Suicide Attempts in Substance Abusers: Effects of Major Depression in Relation to Substance Use Disorders

American Journal of Psychiatry ◽

10.1176/appi.ajp.159.9.1600 ◽

2002 ◽

Vol 159 (9) ◽

pp. 1600-1602 ◽

Cited By ~ 75

Author(s):

Efrat Aharonovich ◽

Xinhua Liu ◽

Edward Nunes ◽

Deborah S. Hasin

Keyword(s):

Substance Use ◽

Major Depression ◽

Substance Use Disorders ◽

Suicide Attempts ◽

Substance Abusers

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Mechanisms of impulsivity in bipolar disorder and related illness

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00000828 ◽

2010 ◽

Vol 19 (2) ◽

pp. 120-130 ◽

Cited By ~ 35

Author(s):

Alan C. Swann

Keyword(s):

Bipolar Disorder ◽

Substance Use ◽

Personality Disorder ◽

Substance Use Disorders ◽

Antisocial Personality Disorder ◽

Suicide Attempts ◽

Affective State ◽

Rapid Response ◽

Antisocial Personality ◽

Course Of Illness

SummaryAims – Impulsivity is a multifaceted aspect of behavior that is prominent in psychiatric disorders and has serious behavioral consequences. This paper reviews studies integrating behavioral and physiological mechanisms in impulsivity and their role in severity and course of bipolar and related disorders. Methods – This is a review of work that used questionnaire, human behavioral laboratory, and neurophysiological measurements of impulsivity or related aspects of behavior. Subjects included individuals with bipolar disorder, substance-use disorders, antisocial personality disorder, and healthy controls. Results – Models of impulsivity include rapid-response impulsivity, with inability to reflect or to evaluate a stimulus adequately before responding, and reward-based impulsivity, with inability to delay response for a reward. In normal subjects, rapid-response impulsivity is increased by yohimbine, which increases norepinephrine release. Impulsivity is increased in bipolar disorder, whether measured by questionnaire, by measures of rapid-response impulsivity, or by measures of ability to delay reward. While affective state has differential effects on impulsivity, impulsivity is increased in bipolar disorder regardless of affective state or treatment. Impulsivity, especially rapid-response, is more severe with a highly recurrent course of illness or with comorbid substance-use disorder, and with history of medically severe suicide attempt. In antisocial personality disorder, rapid-response impulsivity is increased, but rewardbased impulsivity is not. In general, impulsivity is increased more in bipolar disorder than in antisocial personality disorder. In combined bipolar disorder and antisocial personality disorder, increased impulsivity is associated with substance-use disorders and suicide attempts. Conclusions – Impulsivity is associated with severe behavioral complications of bipolar disorder, antisocial personality disorder, and substance-use disorders.

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