title: Prediction of Suicide Ideation and Attempt Among Substance-Using Patients in Primary Care.
abstract: BACKGROUND
  Suicide is a major public health concern, particularly among people who use illicit substances and/or non-prescribed medications.
  
  
  METHODS
  The present study prospectively assessed the incidence and predictors of suicidal ideation (SI) and suicide attempt (SA) among 868 substance-using patients over 12 months after receiving primary care within seven public primary care clinics.
  
  
  RESULTS
  Participants reported a high incidence of SI (25.9%) and SA (7.1%) over the year following primary care visits. Suicidality was elevated in patients who were female; lacked a high school diploma; were unemployed; reported depression, anxiety, hallucinations, concentration difficulty, or violent behavior; used nicotine or stimulants; used the emergency department or mental health services in the past 90 days; reported current quality-of-life impairment in mobility or usual activities; or reported recent SI or lifetime SA at baseline. In multiple regression analyses, only past 30-day SI, any lifetime SA, past 90-day violent behavior, and current impairment due to anxiety or depression at baseline uniquely predicted SI or SA beyond other variables.
  
  
  CONCLUSIONS
  Results support the need for screening for suicidality among primary care patients who use illicit substances and identify key of these patients who are at particularly elevated risk for suicidality.
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle. khallgre@uw.edu.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Hallgren
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Ries
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
authors.forename: David C
authors.initials: DC
authors.lastname: Atkins
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
authors.forename: Kristin
authors.initials: K
authors.lastname: Bumgardner
authors.affiliation: From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
authors.forename: Peter
authors.initials: P
authors.lastname: Roy-Byrne
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014478:Unemployment
chemical_list: D013287:Illicit Drugs
keywords: Anxiety; Depression; Follow-up Studies; Mental Health Services; Primary Health Care; Public Health; Quality of Life; Regression Analysis; Street Drugs; Substance-Related Disorders; Suicidal Ideation; Suicide