Predictors of a suicide attempt one year after entry into substance use disorder treatment.
BACKGROUND
The present study examined the patient intake and treatment-related risk factors associated with a suicide attempt in the 30 days before a 1-year posttreatment assessment.


METHODS
A national sample of 8,807 patients presenting for treatment of substance use disorders (SUDs) in the Department of Veterans Affairs healthcare system were assessed at treatment intake and follow-up. Using the MacArthur Model, the risk and protective factors for suicide attempt were identified at baseline and during treatment.


RESULTS
At follow-up, 4% (314/8,807) of the patients reported a suicide attempt within the past 30 days. Baseline predictors of a suicide attempt before follow-up included elevated suicidal/psychiatric symptoms, more recent problematic alcohol use, and longer duration of cocaine use. Contact with the criminal justice system was a protective factor that reduced the likelihood of a future suicide attempt. Greater engagement in SUD treatment was also associated with a reduction in suicide risk.


CONCLUSIONS
More involvement in SUD treatment reduced the likelihood of a future suicide attempt in high-risk patients. Substance use disorder treatment providers interested in reducing future suicidal behavior may want to concentrate their efforts on identifying at-risk individuals and actively engaging these patients in longer treatment episodes.
Ilgen
Mark A
MA
Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025, USA. mark.ilgen@va.gov
Harris
Alex H S
AH
Moos
Rudolf H
RH
Tiet
Quyen Q
QQ
D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology; D019970:Cocaine-Related Disorders / Q000150:complications / Q000523:psychology; D003415:Crime; D016208:Databases, Factual; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D015233:Models, Statistical; D018570:Risk Assessment; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs