DETERMINANTS OF SUICIDAL IDEATION - THE ROLE OF SUBSTANCE USE DISORDERS

Background: This study tested the hypothesis that the amount of psycho active substance consumed (frequency and/or quantity), life problems r esulting from this use, and a DSM-IV diagnosis of substance abuse/depe ndence are independent risk factors associated with increased suicidal ideation in a population of psychiatric inpatients with major depress ive disorder. Method: 891 hospitalized patients with a primary diagnos is of nonpsychotic major depressive disorder (MDD) received a standard ized, psychic trist-administered assessment battery. To examine the re lationship between admission suicidality and demographic, psychiatric history, and admission variables, chi-square analyses were used for ca tegorical data and one-way ANOVAs were used for continuous indices. St epwise hierarchical multiple regression analyses were performed to det ermine the set of variables that was independently related to admissio n suicidality level. Results: Then was general agreement between our f indings and previous literature in regard to the association between s everity of Axis I diagnosis, depressed mood, hopelessness, male gender , unemployment, involuntary treatment, and alcohol/drug problems and h igher suicidal ideation. In our sample of hospitalized patients with u nipolar major depressive disorder, higher current drug and/or alcohol dependency and high current use of alcohol or other substances of abus e were independently associated with higher levels of suicidal ideatio n. Conclusion: This association with higher suicidal ideation lends su pport to the importance of treating patients for both alcohol/drug pro blems and depression in an effort to decrease their risk for future su icide. We hope that our findings will improve the care that patients w ith dual diagnoses receive.