Prediction of Suicide Ideation and Attempt Among Substance-Using Patients in Primary Care

by | Addiction

http://www.jabfm.org/content/30/2/150.full.pdf+html?sid=1c8dd5ea-1a33-4704-8b59-15cc4a8e52fa

Kevin A. Hallgren, PhD, Richard K. Ries, MD, David C. Atkins, PhD, Kristin Bumgardner, BS, and Peter Roy-Byrne, MD

Background: Suicide is a major public health concern, particularly among people who use illicit substances and/or non-prescribed medications. Methods: The present study prospectively assessed the incidence and predictors of suicidal ideation (SI) and suicide attempt (SA) among 868 substance-using patients over 12 months after receiving primary care within seven public primary care clinics. Results: Participants reported a high incidence of SI (25.9%) and SA (7.1%) over the year following primary care visits. Suicidality was elevated in patients who were female; lacked a high school diploma; were unemployed; reported depression, anxiety, hallucinations, concentration difficulty, or violent behavior; used nicotine or stimulants; used the emergency department or mental health services in the past 90 days; reported current quality-of-life impairment in mobility or usual activities; or reported recent SI or lifetime SA at baseline. In multiple regression analyses, only past 30-day SI, any lifetime SA, past 90-day violent behavior, and current impairment due to anxiety or depression at baseline uniquely predicted SI or SA beyond other variables. Conclusions: Results support the need for screening for suicidality among primary care patients who use illicit substances and identify key subgroups of these patients who are at particularly elevated risk for suicidality. ( J Am Board Fam Med 2017;30:150 –160.)

Note;

It seems that the biggest risk-factors for suicide among primary care patients from this study were;

Past 30-day Suicidal Ideation

History of any lifetime Suicide Attempt

Past 90-day violent behavior, and

Current impairment due to anxiety or depression at baseline

Other risk factors included;

Patients who were female

Lack of a high school diploma

Being unemployed

Self-reported depression, anxiety, hallucinations, concentration difficulty

Violent behavior

Use of nicotine or stimulants

Use of the emergency department or mental health services in the past 90 days

Self-reported current quality-of-life impairment in mobility or usual activities

Reported recent Suicide ideation or lifetime Suicide Attempt

For those of us who do primary care and really for all clinicians, it’s good to have this type of data to know who to take a 2nd look at!

Dr. Raymond Oenbrink
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