title: Investigation of a Suicide Ideation Risk Profile in People With Co-occurring Depression and Substance Use Disorder.
abstract: Disengagement from services is common before suicide, hence identifying factors at treatment presentation that predict future suicidality is important. This article explores risk profiles for suicidal ideation among treatment seekers with depression and substance misuse. Participants completed assessments at baseline and 6 months. Baseline demographics, psychiatric history, and current symptoms were entered into a decision tree to predict suicidal ideation at follow-up. Sixty-three percent of participants at baseline and 43.5% at follow-up reported suicidal ideation. Baseline ideation most salient when psychiatric illness began before adulthood, increasing the rate of follow-up ideation by 16%. Among those without baseline ideation, dysfunctional attitudes were the most important risk factor, increasing rates of suicidal ideation by 35%. These findings provide evidence of factors beyond initial diagnoses that increase the likelihood of suicidal ideation and are worthy of clinical attention. In particular, providing suicide prevention resources to those with high dysfunctional attitudes may be beneficial.
authors.affiliation: *National Drug and Alcohol Research Centre, University of New South Wales, Kensington; †Centre for Rural and Remote Mental Health, University of Newcastle, c/o Bloomfield Hospital, Orange; ‡Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan; §Hunter New England Mental Health Services, Waratah; ∥Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, New Lambton Heights, NSW; and ¶School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Tonelle E
authors.initials: TE
authors.lastname: Handley
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Kay-Lambkin
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Baker
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Kelly
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Inder
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
authors.forename: David J
authors.initials: DJ
authors.lastname: Kavanagh
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry) / Q000379:methods / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*