Substance Use/Abuse and Suicidal Behavior in Young Adult Women: A Population-Based Study

Abstract

Associations between substance use variables and suicidal behavior were analyzed in an urban population sample from (“the Women and Alcohol in Gothenburg” study). In Phase I, 20-year-old women (n = 2,069) completed a screening questionnaire. Interviews were carried out with a stratified sample (n = 560). Data, collected in 1995 and 2000, were analyzed using logistic regression to generate odds ratios. Drug use, but not risky alcohol consumption, was associated with suicidal thoughts after adjusting for current depression. Study limitations and implications for suicide prevention are discussed. The study was funded by the Swedish Research Council and the Alcohol Research Council of Sweden.

RÉSUMÉ

Uso de drogas y conductas suicidas en mujeres jóvenes adultas: Un estudio poblacional

La asociación entre el uso de drogas y conductas suicidas fueron analizadas en una muestra poblacional del estudio Mujeres y Alcohol en Gotemburgo, Suecia. En la fase I, mujeres de 20 años de edad (n = 2,069) completaron una encuesta de sondeo. Posteriormente, se procedió a entrevistar una muestra estratificada (n = 560). Los odd ratios fueron calculados usando regresión logística de la información, recolectada entre 1995 y 2000. El consumo de drogas, pero no el consumo de riesgo de alcohol, fue asociado con tendencias suicidas aún después de que la depresion fuera incluida en el modelo. Limitaciones e implicaciones del estudio relacionadas con la prevención del suicidio son discutidas. El estudio fue financiado por el Consejo Nacional de Investigaciones y por el Consejo de Investigaciones sobre Alcohol en Suecia.

RESUMEN

L'usage de drogues et de comportements suicidaires chez les jeunes femmes adultes: Une étude de population

Le lien entre les variables de substances consommées et les comportements suicidaires a été analysé dans un échantillon de population urbaine provenant de l’étude sur les femmes et l'alcooleffectuée à Göteborg (Suède). Lors de la Phase I, des femmes de 20 ans (n = 2,069) ont rempli un questionnaire de filtrage. Des entretiens ont été effectués avec un échantillon stratifié (n = 560). Les données collectées en 1995 et en 2000 ont été analysées avec une régression logistique permettant de générer des ratios inattendus. Après un ajustement correspondant aux dépressions courantes, c'est la consommation de stupéfiants qui est associée aux pensées suicidaires, et non la consommation d'alcool à risque. Les limites d’étude et les implications dans la prévention des suicides y sont commentées. Cette étude est financée par le Conseil national suédois pour la recherche scientifique et le Conseil suédois de recherche sur l'alcoolisme.

Keywords :

• alcohol
• substance use
• suicidal thoughts
• suicide attempt
• young women

THE AUTHORS

Maud Sundin, MD, is a Senior Consultant in psychiatry at the Substance Use Clinic at Sahlgrenska University Hospital in Gothenburg. Her areas of interest include substance use disorders, liaison psychiatry, personality disorders, and suicidal behavior.

Fredrik Spak, MD, Ph.D., is an Associate Professor at the unit of Social Medicine at the Sahlgrenska Academy, University of Gothenburg. His research interests include the epidemiology of alcohol use disorders, with a special focus on women, and the implementation of secondary prevention programs. He is a Senior Consultant in psychiatry and social medicine and is involved in prevention programs in primary care.

Lena Spak, MD, Ph.D., is a Child and Adolescent Psychiatrist at Queen Silvia Children's Hospital in Gothenburg, and a Guest Teacher and Researcher at the unit of Social Medicine at the Sahlgrenska Academy, University of Gothenburg. Her research focus is on women and alcohol, and especially on the association between early background factors and later alcohol abuse and dependence among women.

Valter Sundh, M.Sc., is a Senior Biostatistician at the Department of Social Medicine and Public Health at Sahlgrenska Academy, University of Gothenburg, with a special emphasis on longitudinal population studies.

Margda Waern, MD, Ph.D., is a Professor of psychiatry at the Section for Psychiatry and Neurochemistry at the Sahlgrenska Academy, University of Gothenburg. Her research focus is on suicidology. She is also a senior consultant in psychiatry at Sahlgrenska University Hospital.

Notes

1 The reader is reminded that the concept of “risk” and “protective” factors is often noted in the literature without adequately noting their dimensions (linear, nonlinear), their “demands,” the critical necessary conditions (endogenously as well as exogenously, from a micro to a macro level), which are necessary for either of these posited processes to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to, and whether their underpinnings are theory driven; empirically based; individual and/or systemic stake holder bound; based upon “principles of faith”; historical observation, precedents, and traditions that accumulate over time; perceptual and judgmental constraints; “transient public opinion”; or what. This is necessary to clarify whether these terms are not to remain as yet additional shibboleths in a field of many stereotypes. Editor's note.