A new study in JAMA Psychiatry finds that female youths between the ages of 8 and 19 who attempted suicide had a substantial risk of hospitalization for a substance use disorder (SUD) later in life compared to female youths who never attempted suicide.
This study analyzed three decades of hospital admittance data for suicide attempts between 1989 and 2019 in Quebec, Canada resulting in data on 5,840 female youths with suicide attempts and included 116,394 population controls, for a total cohort of 122,234 female youths. Compared to female youths with no suicide attempt, female youths who attempted suicide had 6 times the risk of hospitalization for any type SUD and when analyzed by type of SUD, the risk for hospitalization was substantial for sedative or hypnotic use disorders (32x) and hallucinogens (17x) and also elevated for the other types of SUDs including alcohol, stimulants, cocaine, cannabis, and opioids. After adjusting for new onset of mental illness during follow up, suicide attempts continued to be associated with risk of hospitalization for all types of SUDs.
- This research also examined how the risk varied with time and found that while the risk of hospitalization for any type of SUD was 7 times higher within the first five years after the first suicide attempt, the risk continued throughout the length of follow up.
- When analyzed by type of SUD, again the risk was substantial when it came to sedatives or hypnotic use disorder with female youths at 67 times the risk of hospitalization for such disorder within five years of attempting suicide compared to female youths with no suicide attempt.
- The risk of hospitalization was also elevated for the other types of SUDs (hallucinogens, cocaine, alcohol, stimulants, opioids, and cannabis) within five years of attempting suicide.
- The researchers also analyzed how the characteristics of suicide attempt (quantity and method) affected the relationship with hospitalization for SUDs and found a substantial risk associated with a higher number of attempts as well as attempts by violent means.
With this study including a large sample size and spanning over 30 years, the findings are astonishing and underscore the urgent need of not only mental health services but targeted interventions prioritizing substance use prevention to a high risk population, female youths who attempt suicide. As the authors suggest that the association between suicide attempts and later onset of substance use may be due to damage in certain areas of the brain associated with cognitive flexibility that can lead to behavioral changes, extending substance use prevention education to include science-based information regarding the effects of suicide attempts on the brain, may be beneficial to adolescents and warrants further research.
Reference: Auger N, Chadi N, Ayoub A, Brousseau É, Low N. Suicide Attempt and Risk of Substance Use Disorders Among Female Youths. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2022.1025