Prevalence and correlates of suicide attempt among Chinese individuals receiving methadone maintenance treatment for heroin dependence

Bao-Liang Zhong,Bao-Liang Zhong,Bao-Liang Zhong,Jin Lu,Jun-Hong Zhu,Hongxian Chen,Hongxian Chen,Wu-Xiang Xie

doi:10.1038/s41598-019-52440-x

Abstract

To date, there have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence. The objective of this study was to examine the prevalence and correlates of suicide attempt in Chinese individuals receiving methadone maintenance treatment for heroin dependence. Demographic, clinical, and psychosocial data of 603 methadone-maintained patients with heroin dependence were collected with a standardized self-administered questionnaire. The presence of suicide attempt and antisocial personality disorder was assessed by using a single question and the Mini-International Neuropsychiatric Interview 5.0. The one-month and lifetime prevalence rates of suicide attempt were 9.5% and 34.2%, respectively. In multivariable logistic regression, lifetime suicide attempt was significantly associated with female gender (OR = 2.81), being 20–39 years old (OR = 2.73), an education level of primary school or lower (OR = 2.07), poor economic status (OR = 3.06), injecting heroin before methadone maintenance treatment (OR = 2.92), depressive symptoms (OR = 3.46), anxiety symptoms (OR = 1.88), and antisocial personality disorder (OR = 2.85). Suicide attempt is very prevalent among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Services for patients with heroin dependence in methadone maintenance treatment clinics in China should include psychosocial supports, periodic screening for suicide attempt and other suicidal behaviors and, when needed, psychiatric treatment and crisis intervention.

Highlights

To date, there have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence
maintenance treatment (MMT) is effective in reducing withdrawal symptoms and social harms resulting from heroin use and improving quality of life of individuals with heroin dependence (IHD)[30], empirical studies still reported high prevalence rates of psychosocial and physical problems in Chinese IHD receiving MMT such as depression, loneliness, and pain[27,31,32]
The two prevalence figures indicate an extremely high prevalence of suicide attempt in Chinese IHD, because the lifetime prevalence, even the one-month prevalence of suicide attempt in IHD is much higher than the lifetime prevalence in the Chinese general population, which is estimated to be 0.8% only[49]

Summary

Introduction

There have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence. In Western countries, the epidemiology of suicide attempt in individuals with opioid dependence has been extensively studied[10,20,21,22,23,24,25] These studies reported a wide range of lifetime prevalence of attempted suicide in patients with opioid dependence (8.0–48.0%) and a variety of risk factors associated with suicide attempt, including female gender, unemployment, depression, post-traumatic stress disorder, personality disorder, a high degree of aggression/impulsivity, childhood trauma, alcoholism, and addiction severity. MMT is effective in reducing withdrawal symptoms and social harms resulting from heroin use and improving quality of life of individuals with heroin dependence (IHD)[30], empirical studies still reported high prevalence rates of psychosocial and physical problems in Chinese IHD receiving MMT such as depression, loneliness, and pain[27,31,32]

Objectives

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Results

Conclusion