@article{ref1,
title="Acute substance use as a warning sign for suicide attempts: a case-crossover examination of the 48 hours prior to a recent suicide attempt",
journal="Journal of clinical psychiatry",
year="2017",
author="Bagge, Courtney L. and Borges, Guilherme L. G.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: The extent to which specific categories of acute substance use are short-term risk factors, or warning signs, for suicide attempts is unknown. The aim of the current study was to quantify the near-term effects of sole use and co-use of substances on medically attended suicide attempts. <br><br>METHODS: The current study used a case-crossover design, comparing substance use within the 24 hours prior to a suicide attempt (case day) to the control day, the matched 24 hours the day prior to the case day. Participants were 363 recent suicide attempters presenting to a Level 1 trauma hospital between October 2008 and April 2014. A timeline follow-back methodology was used to assess acute exposures within the 48 hours before the suicide attempt. Conditional logistic regression was used to report odds ratios (ORs) and 95% confidence intervals (CIs). <br><br>RESULTS: Results indicated that patients were at increased odds of attempting suicide after drinking alcohol within a 24-hour period (OR = 4.40; 95% CI, 2.31-8.40) and using a drug from another class of substances with central nervous system (CNS) depressant characteristics (sedatives/anxiolytics and opioids; OR = 2.82; 95% CI, 1.13-7.01), after adjustment for other acute substance use. The acute use of cannabis and CNS stimulants (stimulants/amphetamines and cocaine) was not uniquely associated with suicide attempt. Co-use of alcohol synergized effects of other CNS depressants (OR = 8.76; 95% CI, 1.02-75.44). <br><br>CONCLUSIONS: Findings suggest the importance of considering acute alcohol use and use of CNS depressants, and the concurrent use of both substances, when evaluating short-term risk for suicide attempts in clinical settings.<p /> <p>Language: en</p>",
language="en",
issn="0160-6689",
doi="10.4088/JCP.15m10541",
url="http://dx.doi.org/10.4088/JCP.15m10541"
}