Nicotine use in suicides: a case-control study.
OBJECTIVE
Despite of higher rates of substance-related disorders in psychiatric patients and suicides than in the general population, there is no clear specificity to the relationship between nicotine use and other psychiatric disorders for suicide risk.


METHODS
One hundred and sixty-three suicides (mean age 49.8 +/- 19.3 years; 64.4% males; using psychological autopsy method) and 396 control persons (mean age 51.6 +/- 17.0 years; 55.8% males) were assessed with a standardised semi-structured interview including SCID-I and SCID-II (for DSM-IV). Suicides and controls were compared in terms of nicotine consumption and psychiatric disorders. Logistic regression was used to evaluate the interactions of tobacco consumption with psychiatric disorders.


RESULTS
Suicides were significantly more often current smokers and heavy users of cigarettes (> 20 cigarettes per day; P < 0.001, each). Alcohol dependence, other axis I disorders than substance-related disorders, and cluster B personality disorder(s) remained independent predictors for suicide in both genders, current nicotine consumption only in men (OR = 2.6, 95% CI 1.3-5.2).


CONCLUSIONS
In males, but not in females, nicotine consumption contributed to risk of completed suicide after control for psychiatric disorders and has to be considered as independent risk factor for suicide.
Schneider
Barbara
B
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528 Frankfurt/Main, Germany. b.schneider@em.uni-frankfurt.de
Schnabel
Axel
A
Weber
Bernhard
B
Frölich
Lutz
L
Maurer
Konrad
K
Wetterling
Tilman
T
D001344:Autopsy; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000009:adverse effects*; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality*
D000697:Central Nervous System Stimulants; D009538:Nicotine