Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol

Espinet, Stacey D.; Corrin, Tricia; Baliunas, Dolly; Quilty, Lena C.; Zawertailo, Laurie; Rizvi, Sakina J.; deRuiter, Wayne K.; Bonato, Sarah; Luca, Vincenzo De; Kennedy, Sidney H.; Selby, Peter

doi:10.1186/s13643-019-1028-2

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…While mood disorders are among the most important risk factors for suicide [ 3 – 5 ], comorbidity with alcohol and substance use disorders (AUD/SUD) vastly increases vulnerability to suicidal ideation [ 6 , 7 ], attempts [ 8 , 9 ], and deaths [ 5 , 10 , 11 ]. Additionally, suicidal ideation and behavior are significant clinical concerns among those seeking treatment for AUD/SUD [ 12 ], and risk for highly lethal suicide attempts remains to be elevated even after remission from SUD [ 13 ]. While all substances elevate the risk for suicidal behavior, alcohol and opioids are the most common substances identified in suicide decedents (22% and 20%, respectively), far above rates of marijuana (10.2%), cocaine (4.6%), and amphetamines (3.4%) [ 14 •].…”

Section: Introductionmentioning

confidence: 99%

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Rizk

Herzog

Dugad³

et al. 2021

Curr Addict Rep

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Purpose of Review Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior. Recent Findings Among people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior. Summary Further research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.

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Section: Introductionmentioning

confidence: 99%

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Rizk

Herzog

Dugad³

et al. 2021

Curr Addict Rep

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“…In a Canadian study, Espinet et al (2019) found that the lifetime suicide risk for individuals with substance use disorder was 5 -10 times higher than the 3 -5% risk in the general population; for individuals with alcohol abuse problems, it was is 10 times higher; for those using opiates it was 14 times higher and for those with mixed-drug use it was 17 times higher. In addition, Espinet et al reported that these individuals made multiple suicide attempts.…”

Section: Drug and Alcohol Usementioning

confidence: 95%

Domestic Abuse links to Suicide: Rapid Review, Fieldwork, and Quantitative Analysis Report.

Christie¹,

Rockey²,

Bradbury‐Jones³

et al. 2023

Preprint

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Domestic abuse is a widespread problem that has far reaching and grave consequences. To date, very little systematic data have been gathered on the relationship between domestic abuse and victim suicide. To address this gap, we conducted three strands of research, including: 1) Rapid evidence review. The review examined the long- and short-term causes, drivers and aggravating factors of domestic abuse (e.g., physical, emotional, psychological, financial) related suicide, to deliver a strong evidence base for identifying risk factors. 2) Fieldwork. A qualitative study with domestic abuse victims was conducted to better understand the relationship between domestic abuse and risk factors for suicide. 3) Quantitative evaluation. A quantitative study of domestic abuse incidents and suicide to better understand how the incidence of suicide differs amongst the victims and perpetrators of domestic violence, and how this is correlated with its form. Based on our results, we recommend the creation and testing of an assessment tool that aims to identify the predictors of suicide by gathering information from the survivor. Administration of the tool should include gathering information from whether they have experienced life-threatening abuse; sexual assault/rape, coercion and control; multiple abuses and repetition of abuse, as well as information about their feeling states, including feelings of despair, hopelessness and burdensomeness/ isolation/self-hatred. The tool should also take into account the effects of the abuse on the survivor’s self-identity, such as the number of relationships which have been disrupted or terminated. This should also elicit information about a survivor’s perceptions of/relationship with the police (and health services) and may assist in building trust; and any previous or childhood experiences which were trauma or terror-inducing, such as, some form of abuse, disaster (e.g., house fire), accident or medical procedure. Further information should be gathered about the survivor’s coping strategies, such as whether they are using self-harm and/or alcohol and drugs to cope. We also recommend the development of guidelines for police forces and health services to introduce and maintain a domestic abuse survivor suicide prevention/welfare pathway, with local statutory and VCS partners. The framework should contain the information in this report, and any other/up-dated information about how domestic abuse dismantles the survivor’s identity and the link with suicide translated into operational understanding and practice. Additionally, we recommend that a small amount of additional funding is made available to explore the information collected in this research about the contact survivors have had with services other than the police and health services (e.g. children’s social care, schools, housing, immigration services, the Family courts and voluntary and community sector services). Moreover, more nuanced research needs to be undertaken to track the trajectory from abuse to suicidality and, in the process, to differentiate suicide ideation from suicidality. The research should incorporate evaluation of any of the above pilot activities.Finally, given that the quantitative analysis highlights the high rate of suicide amongst male perpetrators of domestic violence, further research is necessary to better understand this relationship and how it is affected by socio-economic factors, mental health, and substance abuse.

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“…Given the unique vulnerabilities of patients with pain conditions and complex interactions of predisposing and enabling factors in this population, suicide prediction models (SPMs) may be effective tools to identify patients at risk and prevent adverse outcomes, including death [ 16 , 17 ]. Although previous SPM studies have shown promising results, few have focused on patients with pain conditions.…”

Section: Introductionmentioning

confidence: 99%

Predictive Modeling for Suicide-Related Outcomes and Risk Factors among Patients with Pain Conditions: A Systematic Review

Huang

Lewis

Bao

et al. 2022

JCM

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Suicide is a leading cause of death in the US. Patients with pain conditions have higher suicidal risks. In a systematic review searching observational studies from multiple sources (e.g., MEDLINE) from 1 January 2000–12 September 2020, we evaluated existing suicide prediction models’ (SPMs) performance and identified risk factors and their derived data sources among patients with pain conditions. The suicide-related outcomes included suicidal ideation, suicide attempts, suicide deaths, and suicide behaviors. Among the 87 studies included (with 8 SPM studies), 107 suicide risk factors (grouped into 27 categories) were identified. The most frequently occurring risk factor category was depression and their severity (33%). Approximately 20% of the risk factor categories would require identification from data sources beyond structured data (e.g., clinical notes). For 8 SPM studies (only 2 performing validation), the reported prediction metrics/performance varied: C-statistics (n = 3 studies) ranged 0.67–0.84, overall accuracy(n = 5): 0.78–0.96, sensitivity(n = 2): 0.65–0.91, and positive predictive values(n = 3): 0.01–0.43. Using the modified Quality in Prognosis Studies tool to assess the risk of biases, four SPM studies had moderate-to-high risk of biases. This systematic review identified a comprehensive list of risk factors that may improve predicting suicidal risks for patients with pain conditions. Future studies need to examine reasons for performance variations and SPM’s clinical utility.

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Predisposing and protective factors influencing suicide ideation, attempt, and death in patients accessing substance use treatment: a systematic review and meta-analysis protocol

Cited by 10 publications

References 22 publications

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders

Domestic Abuse links to Suicide: Rapid Review, Fieldwork, and Quantitative Analysis Report.

Predictive Modeling for Suicide-Related Outcomes and Risk Factors among Patients with Pain Conditions: A Systematic Review

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