This population-based, retrospective cohort study examined the association of tobacco use and diagnosis of a depressive disorder (DD) and suicide attempts (SA) before and after discharge from an inpatient addiction program (IAP). All 813 Olmsted County, Minnesota residents (537 males, 276 females) admitted for the first time to the IAP for treatment of alcoholism during the period 1972-1983 were studied. Tobacco use status at admission was classified as ever (current or former use) (85.5%), never (8.6%), or missing (5.9%). Subjects were followed through 1994. Current or former use of tobacco was markedly lower among those with a prior diagnosis of DD than those without this diagnosis (73.6% vs. 89.3%, p<0.001). Although females were more likely to have a diagnosis of DD and were less likely to have ever used tobacco than males, gender did not explain the relationship between tobacco use and DD. Tobacco use status was unrelated to a DD diagnosis after discharge from the IAP and was not associated with SA.
"However, in our study, only 7.2% of the case group took two simultaneous addictive substances (heroin and hashish). In a study that was conducted among Minnesota residents, there were found no relationship between their addiction to tobacco and the patients’ depression rates after hospital discharge and also their suicide rate.22 "
[Show abstract][Hide abstract] ABSTRACT: The problem of addiction is one of the four global crises. These patients are more vulnerable to mental disorders. This study aimed to examine the risk of suicide in drug dependent patients.
In this cross-sectional study, patients who referred for addiction treatment were selected and the control group was chosen among their companions who did not have narcotic drugs dependence. Suicide risk was assessed through California Suicide Risk Assessment Questionnaire. Beck's Depression Inventory questionnaire was used to assess the depression level.
The comparison of average education (P < 0.01) and the unemployment rate (P = 0.03) and previous attempted suicide (P = 0.01) between the narcotic drug dependent group and control group showed a statistically significant difference. Suicide risk score (P < 0.01) and depression score (P < 0.01) differences were statistically significant. The average scores of depression score in addicts was significantly associated with their previous attempted suicide (P = 0.01). In the control group, there was a significant association in suicide score and depression score with their previous attempted suicide (P < 0.01). Suicide score were compared based on the depression degree in both groups and statistically significant differences were found (P < 0.01).
The suicide risk and depression in drug addicts are more than general population and they are closely related to each other.
"Age, gender, alcohol abuse/ dependence, and affective illness are a few of the identified risk factors for suicidal ideation, suicide attempts and suicide (Bhopal 1992; Sheikh 2000; Crosby et al., 2002; Makikyro et al., 2004; Wu et al., 2004; Kessler et al., 2005; McGee et al., 2005; Sareen et al., 2005; Bromet et al., 2007; Kessler et al., 2007; Oquendo et al., 2007; Bronisch et al., 2008) and also appear to be correlated with smoking (Bhopal 1992; Angst et al., 1998; Anthony et al., 2000; Sheikh 2000; Tanskanen et al., 2000a; Patten et al., 2003; Makikyro et al., 2004; Schumann et al., 2004; Breslau et al., 2005; Iwaski et al., 2005; Kessler et al.,2005; McGee et al., 2005; Sareen et al., 2005; Falk et al., 2006; Kessler et al., 2007; Oquendo et al., 2007; Riala et al., 2007b; Bronish et al., 2008). Individuals who suffer from mental health conditions, such as depressive disorders, anxiety symptoms, or alcohol abuse/dependence are at a significantly greater risk of experiencing suicidal ideation, attempting suicide and dying by suicide compared to those without these disorders (Robins et al., 1959; Coombs et al., 1992; Schaffer 1993; Sheikh 2000; Crosby et al., 2002; Breslau et al., 2005; De Leo et al., 2005; McGee et al,. "
[Show abstract][Hide abstract] ABSTRACT: The incidence rate of suicidal ideation among current and former smokers versus never smokers is not known. In this study, the age-adjusted incidence of suicidal ideation was highest among current smokers, followed by former, then never smokers. The adjusted hazard for suicide ideation was 2.22 (95%CI = 1.48, 3.33) and 1.19 (95%CI = 0.78, 1.82) for current and former smokers, respectively, compared to never smokers. Results indicate that current smokers have increased risks of suicidal ideation above and beyond the risk for never and former smokers regardless of age, gender, history of depressive disorder or anxiety symptoms, and alcohol abuse/dependence. Smoking cessation might be beneficial for some suicide prevention efforts.
"Fifth, there could be also an interaction between different risk factors predisposing to suicidality. Mental disorders such as depression and addiction, promote smoking which in turn leads to suicidality (Breslau et al., 2004b; Sher et al., 2005; Patten et al., 2003). In a clinical prospective study Oquendo et al. (2004) found to be the most powerful predictive factors of future suicide attempts the subjective rating of the severity of depression, as well as cigarette smoking, each of which was associated with future risk of suicidality in patients with major depressive disorder or bipolar disorder. "
[Show abstract][Hide abstract] ABSTRACT: The temporal relationship between smoking and suicidality is not yet clear. This article examines associations between smoking and suicidality and their temporal ordering of onset.
Baseline and four-year follow-up data were used from the Early Developmental Stages of Psychopathology (EDSP) study, a prospective longitudinal study of adolescents and young adults in Munich, Germany. We assessed smoking (occasional and regular), nicotine dependence, suicidal ideation and suicide attempts using the standardized Munich-Composite International Diagnostic Interview (M-CIDI).
Suicide ideation and suicide attempts were strongly associated with occasional and regular smoking and nicotine dependence at baseline (Odds ratios [OR] range from 1.4 to 16.4). In the prospective analyses, prior occasional, regular smoking and nicotine dependence increased the risk for new onset of suicide ideation (OR range from 1.5 to 2.7) and prior regular smoking and nicotine dependence increased also the risk for onset of suicide attempt(s) (OR range between 3.1 and 4.5). Pre-existing suicidality could not be shown to be associated with subsequent smoking or nicotine dependence. Associations remained stable when participants who fulfilled DSM-IV-criteria for major depression were excluded.
The sample is confined to an age cohort of 14 to 24 years. No completed suicides could be observed.
The presence of associations between prior smoking and subsequent suicidality, in concert with the lack of associations between prior suicidality and subsequent smoking suggests the existence of an independent pathway from smoking to suicidality.
Jacqueline M Barker, Daniel H Lench, L Judson Chandler
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