Suicidal attempts among patients with substance use disorders who present with suicidal ideation [2018]

• Patients with addiction problems have a great risk of suicidal ideation and attempts.

• There are differences in patients in the different stages of suicidal behaviour.

• Among suicidal ideators, 39.6% had attempted suicide.

• Patients who attempt suicide show a worse clinical profile.

• Screening of suicidal risk in patients seeking treatment for addiction is necessary.

Background and aims
Patients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction problems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and to explore the differential characteristics for suicide ideators with and without suicide attempts.

A sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed.

Information concerning socio-demographic characteristics, addiction severity, and psychopathological symptoms was obtained.

In total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%–47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to everyday life than patients with only suicidal ideation. Specifically, three psychopathological variables were related to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium.

According to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition.

José J. López-Goñi, Javier Fernández-Montalvo, Alfonso Arteaga, Begoña Haro

Addictive Behaviors, Volume 89, February 2019