Citation

Ogeil RP, Witt K, Scott D, Smith K, Lubman DI. J. Affect. Disord. 2020; 265: 364-371.

Affiliation

Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia; Turning Point, Eastern Health, 110 Church St., Richmond, VIC 3121, Australia; Monash Addiction Research Centre, Frankston, VIC 3199, Australia.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jad.2019.11.158

PMID

32090761

Abstract

BACKGROUND: Sleep disturbances are among the top-ten warning signs for suicide, however there has been limited investigation of the relationship between these variables in acute presentations, particularly community settings. We examined ambulance attendances for suicide ideation and attempt to explore the role of sleep and co-morbid factors (mental health symptoms, attendance time, and alcohol and benzodiazepine use).

METHODS: Coded clinical records from Ambulance Victoria for the period 1 January 2012 to 30 June 2017 were analysed.

RESULTS: Paramedics attended 97,198 cases of suicidal ideation or suicide attempt during the study period. Just over half (56.4%) of these were for suicidal ideation, and 43.6% were for attempted suicide. Depression symptomology-related attendances were more common than those for anxiety and despite a lower proportion of both sleep and current anxiety-related symptoms, benzodiazepine use was significantly more common in attendances for suicide attempts (25.9%) than for ideation (2.2%). Co-morbid benzodiazepine use was associated with attempted suicide (OR: 10.37 (10.04-10.72), in a hierarchical regression model. LIMITATIONS: Data represent self-report/paramedic observation only, and do include validated measures of sleep or drug use. Sleep disturbance is likely under recorded in ambulance attendances given the primary role of paramedics is to stabilise patients, and minimise risk of harm during transport.

CONCLUSION: This study reports internationally unique data, and provides the first examination of ambulance coded clinical records for suicide ideation and attempt. Sleep disturbances had a unique role in these attendances, over and above common co-occurring factors including drug use and mental health diagnoses.

Copyright © 2019 Elsevier B.V. All rights reserved.

Language: en

Keywords

Benzodiazepines; Drug use; Sleep; Suicide attempt; Suicide ideation