Abstract

ObjectivesTo determine the demographic predictors of suicidal behaviors and measure the association between the spectrum of substance use disorders (SUD) and hospitalization for suicidal behaviors in the adolescent population.MethodsWe conducted a cross-sectional study using the nationwide inpatient sample and included 466,244 adolescent inpatients with psychiatric illnesses. The study sample was sub-grouped into suicidal (N = 182,454) and non-suicidal (N = 283,790) cohorts. The odds ratio (OR) of association for demographic characteristics and comorbid SUD in the suicidal group was evaluated using a logistic regression model witha P-value < 0.01.ResultsOur study population included 466,244 adolescent inpatients. Females had higher odds of suicidal behaviors (OR 1.45; 95% CI 1.431-1.470) compared to males. The most prevalent comorbid SUD among suicidal inpatients was cannabis (15.3%) but had a statistically non-significant association with suicidal behaviors (OR 0.98; 95% CI 0.95-0.99). Inpatients with alcohol use disorders had significantly increased odds of association with suicidal behaviors (OR 1.18; CI: 1.142-1.209) compare to other SUD. Among other substances (cannabis and stimulants), there existed a statistically non-significant association with hospitalization for suicidal behaviors.ConclusionAdolescent inpatients with comorbid alcohol use disorders were at 18% higher odds of hospitalization for suicidal behaviors. Our study provides a basis for more research while also suggesting potential avenues for early identification and intervention efforts for comorbid SUD in adolescents requiring psychiatric care to improve their prognosis and quality of life.

Highlights

  • Substance use disorders (SUD) have serious consequences for children and adolescents’ physical and mental health

  • The most prevalent comorbid substance use disorders (SUD) among suicidal inpatients was cannabis (15.3%) but had a statistically non-significant association with suicidal behaviors

  • Adolescent inpatients with comorbid alcohol use disorders were at 18% higher odds of hospitalization for suicidal behaviors

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Summary

Introduction

Substance use disorders (SUD) have serious consequences for children and adolescents’ physical and mental health. The lifetime prevalence of any illicit substance use among adolescents is 42.9% [1]. The most commonly abused substance among teens is alcohol as they consume about 1/10th of all alcohol consumed in the United States (US), followed by tobacco and cannabis [2]. According to a 2019 youth risk behavior survey (YRBS) in the US, 14.8% of high school students used illicit substances, 14.3% misused prescription opioids, and 1.6% have injected illegal substances. The overall percentage of substance use has decreased among Caucasians and Hispanics, but it has remained unchanged in African Americans during this 10-year trend descriptive study. High-risk substance use behaviors have declined since 2009, nearly one in every seven adolescents still report drug use and misuse [3]

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