@article{ref1,
title="Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nationwide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder",
journal="Addiction",
year="2017",
author="Østergaard, Marie L. D. and Nordentoft, Merete and Hjorthøj, Carsten",
volume="112",
number="7",
pages="1250-1259",
abstract="AIM: To estimate and test associations between substance use disorders (SUDs) and both completed suicides and suicide attempts in a population with severe mental illness. <br><br>DESIGN: Register-based cohort study with adjusted Cox regression of substance use disorders as time-varying covariates. SETTING: Denmark. PARTICIPANTS: People born in Denmark since 1955 with a diagnosis of schizophrenia (n = 35,625), bipolar disorder (n = 9,279), depression (n = 72,530), or personality disorder (n = 63,958). MEASUREMENTS: Treated SUDs of alcohol and illicit substances identified in treatment registers. Suicide attempt identified in treatment registers. Completed suicides identified in the Cause of Death register. Covariates were sex and age at diagnosis. <br><br>FINDINGS: Having any SUD was associated with at least a threefold increased risk of completed suicide when compared with those having no SUD. Alcohol misuse was associated with an increased risk of completed suicide in all populations with hazard ratios (HR) between 1.99 (95% CI: 1.44-2.74) and 2.70 (95% CI: 2.40-3.04). Other illicit substances were associated with a two- to threefold risk increase of completed suicide in all populations except bipolar disorder, and cannabis was only associated with increased risk of attempted suicide in people with bipolar disorder (HR: 1.86, 95% CI: 1.15-2.99). Alcohol and other illicit substances each displayed strong associations with attempted suicide, HR ranging from 3.11 (95% CI: 2.95-3.27) to 3.38 (95% CI: 3.24-3.53) and 2.13 (95% CI: 2.03-2.24) to 2.27 (95% CI: 2.12-2.43), respectively. Cannabis was only associated with suicide attempts in people with schizophrenia (HR: 1.11, 95% CI: 1.03-1.19). <br><br>CONCLUSION: Substance use disorders are strongly associated with risk of completed suicides and suicide attempts in people with severe mental illness.<br><br>This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0965-2140",
doi="10.1111/add.13788",
url="http://dx.doi.org/10.1111/add.13788"
}