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Heroin-dependent patients attempting and not attempting suicide: a comparison

Published online by Cambridge University Press:  24 June 2014

Ayhan Kalyoncu ,
Hasan Mırsal ,
Özkan Pektaş ,
Devran Tan  and
Mansur Beyazyürek
Ayhan Kalyoncu*
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Hasan Mırsal
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Özkan Pektaş
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Devran Tan
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
Mansur Beyazyürek
Affiliation:
Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
*
Ayhan Kalyoncu, MD, Balıklı Rum Hastanesi Vakfı, Anatolia Klinikleri, BelgradKapı Yolu No:2 Zeytinburnu, Istanbul, Turkey. Tel: +90 212 5471600; Fax: +90 212 5102075; E-mail: akalyon@superonline.com
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Abstract

Objective:

Heroin dependence is a serious illness associated with an increased risk of suicidal behaviour. There are many risk factors associated with heroin dependence. The current study examined the sociodemographic and clinical characteristics of a number of young adult heroin-dependent patients who had attempted suicide.

Methods:

We studied a group of 108 young adult heroin-dependent patients in our in-patient clinics. All diagnoses were made according to DSM-IV diagnostic criteria using the Structured Clinical Interview for DSM-IV Axis I-II Disorders (SCID-I, II). The age range of patients was 18–24 years. Their substance abuse histories were assessed by semistructured interview. The Addiction Severity Index (ASI) was administered to all the patients. Serum total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels were routinely measured. In the statistical analyses, Student’s t test, and chi-squared tests were applied.

Results:

Of the 108 heroin-dependent patients, 40 (37.0%) had histories of attempted suicide. There was a statistically significant difference in the age at which heroin use had commenced between female attempters [mean = 16.82, standard deviation (SD) = 3.06] and nonattempters (mean = 18.32, SD = 2.68, t= 2.25, P < 0.05). Both the male (mean = 33.35, SD = 4.05) and the female (mean = 28.00, SD = 5.36) attempters had significantly higher ASI scores than did the male (mean = 20.16, SD = 3.80) and the female (mean = 18.88, SD = 4.14) nonattempters (t= 14.34, P < 0.001; t= 5.25, P < 0.001, respectively). A significant difference in total cholesterol (mean = 131.8, SD = 19.3; mean = 172.2, SD = 21.3, t= 3.9, P < 0.05) and HDL-C (mean = 30.9, SD = 1.0 and mean = 54.8, SD = 13.7; t= 5.1, P < 0.05) levels between the group of violent and nonviolent suicide attempters was revealed.

Conclusions:

These results suggest that suicide attempts in young adult heroin-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels. In particular, low levels of total cholesterol and HDL-C might indeed be associated with violent suicide attempts in young heroin-dependent patients.

Keywords

characteristicscholesterolheroin dependencesuicide
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 19 , Issue 5 , October 2007 , pp. 297 - 303
Copyright
Copyright © 2007 Blackwell Munksgaard

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References

Anderson, BA, Howard, MO, Walker, RD, Suchinsky, RT. Characteristics of substance-abusing veterans attempting suicide: a national study. Psychol Rep 1995;77:1231–1242. CrossRefGoogle ScholarPubMed
Borges, G, Walters, EE, Kessler, RC. Associations of substance use, abuse, and dependence with subsequent suicidal behavior. Am J Epidemiol 2000;151:781–789. CrossRefGoogle ScholarPubMed
Young, M, Fogg, L, Scheftner, W, Fawcett, J. Interactions of risk factors in predicting suicide. Am J Psychiatry 1994;151:434–435. Google ScholarPubMed
Murphy, SL, Rounsaville, BJ, Eyre, S, Kleber, HD. Suicide attempts in treated opiate addicts. Compr Psychiatry 1983;24:79–89. CrossRefGoogle ScholarPubMed
Shaffer, D, Gould, MS, Fisher, Pet al. Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 1996;53:339–348. CrossRefGoogle ScholarPubMed
Appleby, L. Drug misuse and suicide: a tale of two services. Addiction 2000;95:175–177. CrossRefGoogle ScholarPubMed
Mann, JJ, Oquendo, M, Underwood, MD, Arango, V. The neurobiology of suicide risk: a review for the clinician. J Clin Psychiatry 1999;60(Suppl. 2):7–11. Google ScholarPubMed
Farrell, M, Neeleman, J, Griffiths, P, Strang, J. Suicide and overdose among opiate addicts. Addiction 1996;91:321–333. CrossRefGoogle ScholarPubMed
Darke, S, Ross, J. Suicide among heroin users: rates, risk factors and methods. Addiction 2002;97:1383–1394. CrossRefGoogle ScholarPubMed
Galanter, M, Castaneda, R. Self-destructive behavior in the substance abuser. Psychiatr Clin North Am 1985;8:251–261. Google ScholarPubMed
Harris, EC, Barraclough, B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997;170:205–228. CrossRefGoogle ScholarPubMed
Kjelsberg, E, Winther, M, Dahl, AA. Overdose deaths in young substance abusers: accidents or hidden suicides? Acta Psychiatr Scand 1995;9:236–242. CrossRefGoogle Scholar
Iribarren, C, Reed, DM, Wergowske, G, Burchfiel, CM, Dwyer, JH. Serum cholesterol levels and mortality due to suicide and trauma in the Honolulu Heart Program. Arch Intern Med 1995;155:695–700. CrossRefGoogle ScholarPubMed
Ellison, LF, Morrison, HI. Low serum cholesterol concentration and risk of suicide. Epidemiology 2001;12:168–172. CrossRefGoogle ScholarPubMed
Maes, M, Smith, R, Christophe, Aet al. Lower serum high-density lipoprotein cholesterol (HDL-C) in major depression and in depressed men with serious suicidal attempts: relationship with immune-inflammatory markers. Acta Psychiatr Scand 1997;95:212–221. CrossRefGoogle ScholarPubMed
Cowan, ML, Maxwell, JD. Treatment of hepatitis C virus infection in intravenous drug users. Acta Neuropsychiatrica 2006;18:183–192. CrossRefGoogle ScholarPubMed
Yücel, M, Lubman, DI, Velokoulis, Det al. Structural brain correlates of alcohol and cannabis use in recreational users. Acta Neuropsychiatrica 2006;18:226–229. CrossRefGoogle ScholarPubMed
APA. Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC: American Psychiatric Association, 1994. Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. “Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I)”, clinical version. Washington, DC: American Psychiatric Association, 1997. Google Scholar
Çorapçioğlu, A, Aydemir, Ö, Yildiz, M, Esen, A, Köroğlu, E. “Structured Clinical Interview for Axis I Disorders”, clinical version. Ankara: Hekimler Yayın Birliği, 1999. [in Turkish]Google Scholar
Spitzer, RL, Williams, JBW, Gibbon, M, First, MB. Structured Clinical Interview for DSM-III-R Axis II Disorders (SCID-II). Washington, DC: American Psychiatric Press, Inc., 1990. Google Scholar
Sorias, S, Saygili, R, Elbi, H. “Structured Clinical Interview for DSM-III-R, Turkish version, Personality Disorders Form: SCID-II. İzmir: Ege Üniversitesi Basımevi, 1990. [in Turkish]. Google Scholar
Lewis, JA, Dana, RQ, Blevins, GA. Substance abuse counseling: an individualized approach, 2nd edn. Pacific Grove, CA: Brooks/Cole Publishing Company, 1994. Google Scholar
Linehan, MM, Nielsen, SL. Assessment of suicide ideation and parasuicide: hopelessness and social desirability. J Consult Clin Psychol 1981;49:773–775. CrossRefGoogle ScholarPubMed
Bayam, G, Dilbaz, N, Bitlis, V, Holat, H, Tüzer, T. Assessment of suicidal behavior and depression, hopelessness, suicide ideation: the validity and reliability of the “Suicidal Behaviors Scale”. Kriz Dergisi 1995;3:223–225. [in Turkish]. CrossRefGoogle Scholar
Mclellan, AT, Luborsky, L, Woody, GE, O’Brien, CP. An improved diagnostic instrument for substance abuse patients: the Addiction Severity Index. J Nerv Ment Dis 1980;168:26–33. CrossRefGoogle ScholarPubMed
Fink, LA, Bernstein, D, Handelsman, L, Foote, J, Lovejoy, M. Initial reliability and validity of the childhood trauma interview: a new multidimensional measure of childhood interpersonal trauma. Am J Psychiatry 1995;152:1329–1335. Google ScholarPubMed
Aslan, H, Alparslan, N. The reliability, validity and factor structure of the Childhood Trauma Questionnaire among a group of university students. Türk Psikiyatri Derg 1999;10:275–285. [in Turkish]. Google Scholar
Darke, S, Ross, J. The relationship between suicide and overdose among methadone maintenance patients in Sydney, Australia. Addiction 2001;96:1443–1453. CrossRefGoogle ScholarPubMed
Rossow, I, Lauritzen, G. Shattered childhood: a key issue in suicidal behavior among drug addicts. Addiction 2001;94:209–219. CrossRefGoogle Scholar
Vingoe, L, Welch, S, Farrell, M, Strang, J. Heroin overdose among a treatment sample of injecting drug misusers: accident or suicidal behaviour? J Subst Abuse 1999;4:88–91. Google Scholar
Lynskey, M, Degenhardt, L, Hall, W. Cohort trends in youth suicide in Australia. Aust N Z J Psychiatry 2000;34:408–412. Google ScholarPubMed
Appleby, L, Cooper, J, Amos, T, Faragher, B. Psychological autopsy study of suicides by people under 35. Br J Psychiatry 1999;175:168–174. CrossRefGoogle ScholarPubMed
Beautrais, AL, Joyce, PR, Mulder, RT. Risk factors for serious suicide attempts among youths and adults aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 1996;35:1174–1182. CrossRefGoogle ScholarPubMed
Hassan, R. Suicide explained. The Australian experience. Melbourne: Melbourne University Press, 1995. Google Scholar
Shepherd, DM, Barraclough, BM. Work and suicide: an empirical investigation. Br J Psychiatry 1980;136:469–478. CrossRefGoogle Scholar
Tunving, K. Fatal outcome in drug addiction. Acta Psychiatr Scand 1988;77:551–566. CrossRefGoogle ScholarPubMed
Bukstein, OG, Brent, DA, Perper, JAet al. Risk factors for completed suicide among adolescents with a lifetime history of substance use: a case-control study. Acta Psychiatr Scand 1993;88:403–408. CrossRefGoogle Scholar
Fergusson, DM, Lynskey, MT. Childhood circumstances, adolescent adjustment, and suicide attempts in a New Zealand Birth Cohort. J Am Acad Child Adolesc Psychiatry 1995;34:612–622. CrossRefGoogle Scholar
Garnefski, N, Diekstra, RFW. Child sexual abuse and emotional and behavioural problems in adolescence: gender differences. J Am Acad Child Adolesc Psychiatry 1997;36:323–329. CrossRefGoogle Scholar
Dube, SR, Anda, RF, Felitti, VJ, Chapman, DP, Williamson, DF, Giles, WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span. JAMA 2001;286:3089–3096. CrossRefGoogle ScholarPubMed
Darke, S, Ross, J. Polydrug dependence and psychiatric comorbidity among heroin injectors. Drug Alcohol Depend 1997;48:135–141. CrossRefGoogle ScholarPubMed
Limbeek, JV, Wouters, L, Kaplan, C, Geerlings, PJ, Alem, VV. Prevalence of psychopathology in drug addicted Dutch. J Subst Abuse Treat 1992;9:43–52. CrossRefGoogle Scholar
Gossop, M, Steward, D, Treacy, S, Marsden, J. A prospective study of mortality among drug misusers during a four-year period after seeking treatment. Addiction 2002;97:39–47. CrossRefGoogle Scholar
Oyefeso, A, Ghodse, H, Clancy, C, Corkery, JM, Goldfinch, R. Drug-related mortality: a study of teenage addicts over a 20-year period. Soc Psychiatry Psychiatr Epidemiol 1999;34:437–441. CrossRefGoogle Scholar