Substance use, suicidality, and adolescent-onset schizophrenia: an Israeli 10-year retrospective study.
OBJECTIVE
The aim of this study was to investigate the link between the use of specific types of substances and suicidality in adolescent inpatients with schizophrenia and schizoaffective disorder.


METHODS
We performed a 10-year naturalistic retrospective study of 178 adolescent inpatients diagnosed as suffering from either schizophrenia or schizoaffective disorder. A comparison was made between the suicide-attempting adolescent inpatients and the non-attempting subjects, by the use of specific types of substances, measurements of psychotic, depressive, and aggressive symptoms, and clinical data reported during their hospitalization.


RESULTS
The suicide attempters reported considerably greater usage of inhalants and lysergic acid diethylamide (LSD). Alcohol and methylene-dioxy-methylamphetamine (MDMA) were also used significantly more by this group. However, no differences were found in the usage of cannabis, amphetamines, cocaine, and opiates. The suicide-attempting patients were found to have had more previous psychiatric admissions, a greater level of deliberate self-harm behavior, and a higher level of suicide ideation, but a decreased severity of psychotic symptoms.


CONCLUSIONS
This study is the first report of the association between specific types of substances and suicidality in the high-risk population of adolescent psychotic inpatients. The strong association between inhalants, LSD, alcohol, and MDMA with suicidality is relevant to suicide prevention and intervention programs in adolescent-onset schizophrenia.
Shoval
Gal
G
Adolescent Inpatient Unit, Geha Mental Health Center, Petah Tiqva, Israel. shovgal@post.tau.ac.il
Sever
Jonathan
J
Sher
Leo
L
Diller
Robyne
R
Apter
Alan
A
Weizman
Abraham
A
Zalsman
Gil
G
D000293:Adolescent; D017668:Age of Onset; D000374:Aggression / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology; D012189:Retrospective Studies; D012565:Schizophrenic Psychology; D016728:Self-Injurious Behavior; D019966:Substance-Related Disorders / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*