Karin Monshouwer

Universiteit Utrecht, Utrecht, Utrecht, Netherlands

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Publications (2)3.7 Total impact

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    ABSTRACT: Substance use and suicide attempts are high-risk behaviors in adolescents, with serious impacts on health and well-being. Although multiple substance use among young people has become a common phenomenon, studies of its association with suicide attempts are scarce. The present study examines the association between multiple substance use and self-reported suicide attempts in a large multinational sample of adolescent students in Europe. Data on multiple substance use (tobacco, alcohol, tranquillizers/sedatives, cannabis, other illegal drugs) and self-reported suicide attempts were drawn from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). The ESPAD survey follows a standardized methodology in all participating countries. The present study is based on 45,086 16-year-old adolescents from 16 countries that had used the optional "psychosocial module" of the questionnaire, thereby including the question on suicide attempts. Logistic regression analyses were performed to examine the associations of any self-reported suicide attempt (dependent variable) with substance use controlling for country and gender. The strongest association with self-reported suicide attempts was for any lifetime tranquillizer or sedative use (odds ratio 3.34, 95 % confidence interval 3.00-3.71) followed by any lifetime use of illegal drugs other than cannabis (2.41, 2.14-2.70), 30-day regular tobacco use (2.02, 1.84-2.21), 30-day frequent alcohol use (1.47, 1.32-1.63) and any 30-day cannabis use (1.37, 1.18-1.58). The odds ratio of reporting a suicide attempt approximately doubled for every additional substance used. These findings on the association between multiple substance use, including legal drugs (tranquillizers or sedatives and tobacco), and the life-threatening behavior of suicide attempts provide important cues for shaping prevention policies.
    European Child & Adolescent Psychiatry 04/2012; 21(8):443-50. · 3.70 Impact Factor
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    ABSTRACT: Aims: We describe types of polydrug use among school students across Europe and explore differences between high, medium and low drug prevalence countries. Method: Analysis is based on survey data from over 70,000 15- to 16-year-old school students in 22 European countries. Polydrug use (defined as the use of two or more listed substances during the last 30 days) is compared across three country clusters based on drug prevalences by hierarchical cluster analysis. Affinity between substances is measured by pairwise associations and regression analysis was used to assess the differences in rate ratio across the country clusters. Results: A third of all school students had consumed two or more substances. The most common combinations were: alcohol and cigarettes, followed by alcohol or cigarettes combined with cannabis, followed by alcohol or cigarettes, cannabis and at least one other illegal drug. Pairwise associations show that cannabis and cocaine users are more likely to use illegal drugs than the general student populations but least likely to do so in countries with high prevalence levels (p < 0.0005). Conclusion: Consideration of country differences and objective measures for the concept of normalization could help to inform more holistic prevention initiatives that respond to country-specific contexts.
    06/2010; 17(4):287-302.