Риск суицидального поведения при депрессии в структуре биполярного аффективного расстройства, осложненного зависимостью от растительных каннабиноидов

Abstract

Introduction. According to clinical observations, depressive states in the structure of bipolar disorder (BD) are observed in 23.8% of the examined patients. Most studies show that compared with the general population, the standardized mortality rate in patients is about 30%; BD patients account for 1.4% of total deaths. Aim. To assess the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid ad¬diction. Materials and methods. For this research, 58 patients with diagnosed BD associated with the syndrome of cannabinoid addiction were selected – the main group (mean age 34 ± 4 years). The control group consisted of 100 individuals with BD without associated pathology (mean age 32 ± 3 years). The duration of the disease in both groups ranged from 1 to 5 years. The following methods and scales were used in the study: clinical method – mental status assessment, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the SAD PERSONS Scale – a scale for suicide risk assessment. Results. The study showed that the risk of suicidal behavior in depression in the structure of BD complicated by plant cannabinoid addiction increases significantly, which is confirmed by the results of assessment using psychometric scales (after 6 months since the beginning of the study in the main group, a high risk of suicide was diagnosed in 8% of cases, after 12 months – in 11%, very high risk – in 4% of cases). The deterioration of the mental state was confirmed by the frequency and longer duration of hospitalizations in a psychiatric hospital: in the main group, the average duration of hospitalization in a psychiatric hospital after 6 months since the beginning of the study was about 5.3 ± 2 months (67% (p < 0.005)), after 12 months – about 5.9 ± 1 months (72% (p < 0.005)). In the treatment of this category of patients, high drug resistance was noted (73–86% (p < 0.05)). Conclusion. The use of plant cannabinoids increases the risk of suicidal behavior. Depression in the structure of BD associated with plant cannabinoid addiction was characterized by resistance to therapy. An increase in anxiety levels led to compulsive suicide attempts which is a key risk factor for completed suicide.