Distal Factors of Suicidal Behavior among Patients with Substance Use Disorder: A Comparative Study

Abstract

Background: According to the World Health Organization, substance dependence is persistent or sporadic drug use inconsistent with or unrelated to acceptable medical practice. Substance dependence is showing a rising trend all over the world, and these disorders are rapidly recognized throughout in India. It is considered as a major cause of preventable ill health, social harm, and premature death throughout the population. As compared to the general population, those with substance use disorders are 5.3% more likely to die from suicide. There are several distal or predisposing risk factors associated with suicidal behavior such as personality traits, childhood trauma, and family history of suicide. Therefore, the present study is to compare and examine the distal factors of suicidal ideation (SI) and suicidal attempt (SA) with patients without SI and SA (WS) in patients with substance dependence. Materials and Methods: This was a cross-sectional observational study conducted at the inpatient departments of Central Institute of Psychiatry, Ranchi. Purposive sampling of sixty patients was done to further divide them into Group 1 (SI), Group 2 (SA), and Group 3 (WS). The sample was purposively collected to include sixty patients with substance dependence. They were screened by using the Addiction Severity Index scale, and Beck Scale for Suicidal Ideation (BSSI), Suicide Intent Scale, Childhood Trauma Questionnaire (CTQ), and the NEO five-factor inventory-3 (NEO-FFI-3) were administered to assess SI, SA, childhood trauma and personality traits, respectively. Results: The present study reveals that all the personality domains except conscientiousness on NEO-FFI 3 may have importance in differentiating the substance-dependent patients with SI/SA from WS patients. Only physical and emotional abuse on CTQ may be a significant distal factor for suicidal thoughts and behavior, whereas physical abuse may have more significance for SAs in substance dependence patients. Family history of suicide was not significant in patients with SI/SA. Conclusions: These findings may assist in formulation of therapeutic strategies for suicidal patients of substance dependence.