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Abstract
Suicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
Highlights
Suicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs)
This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs)
Among patients with RTBs, binge drinking was present in 75% of the sample, dangerous driving and risky sexual behaviors were present in 37.5%, gambling in 32.5%, and extreme sport activities in 12.5%
Summary
Suicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. SB emerges as the by-product of a multifactorial process that integrates at various levels of complexity, including neurobiological, psychiatric, psychological, socio-economic, and cultural factors This concept has been incorporated into comprehensive models which have the heuristic interest of generalizing and testing hypotheses in the pathogenesis of SB to detect highly vulnerable subjects (Hawton and van Heeringen 2009; Turecki and Brent 2016). A sequencing of these vulnerability factors into distal and proximal ones, with several socio-demographic variables playing a role of moderators between them, has been conceptualized in the “neurodevelopmental model,” which emphasizes the concept of an individual vulnerability life-trajectory, and interacting and managing environmental influences at any moment (Turecki et al 2012; Turecki and Brent 2016)
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