Subscribe to RSS
DOI: 10.1055/a-0947-2975
Suizidalität bei Abhängigkeit von illegalen Substanzen und psychotrop wirksamen Medikamenten
Suicidality in Dependence on Illegal Substances and Psychotropic DrugsPublication History
Publication Date:
07 August 2019 (online)
![](https://www.thieme-connect.de/media/suchttherapie/201903/lookinside/thumbnails/656_10-1055-a-0947-2975-1.jpg)
Zusammenfassung
Psychische Erkrankungen sind die wichtigsten einzelnen Risikofaktoren für Suizid, wobei Abhängigkeitserkrankungen eine bedeutende Rolle spielen. In diese Übersicht wurden Kohortenstudien und kontrollierte psychologische Autopsiestudien sowie Reviews, die bis 2019 publiziert wurden, zum Risiko für suizidales Verhalten einschließlich Suizid, bei Abhängigkeit von psychotrop wirksamen Medikamenten (Opioiden und Benzodiazepinen) und Konsum von illegalen Substanzen eingeschlossen. Bei allen untersuchten substanzbezogenen Störungen, insbesondere bei Konsum von Opioiden und Mischkonsum, war das Suizidrisiko stark erhöht. So ist beispielsweise bei Drogenabhängigkeit das Suizidrisiko etwa um das 20-Fache gegenüber der Allgemeinbevölkerung erhöht.
Zusammenhänge zwischen Konsum von Drogen und Medikamenten und Entstehung von Suizidalität sind sehr komplex, was sich letztlich auch auf Möglichkeiten der Suizidprävention bei Suchterkrankungen auswirkt.
Abstract
Mental illness is the most important single risk factor for suicide, with dependence disorders playing an important role. This review included cohort studies and controlled psychological autopsy studies and reviews published up to 2019 on the risk of suicidal behaviour including suicide, dependence on psychotropic drugs (opioids and benzodiazepines) and use of illicit substances. The risk of suicide was highly increased in all substance-related disorders studied, especially in opioid and mixed use. For example, the risk of suicide in drug addicts is about 20 times higher than that in the general population.
The relationship between the consumption of drugs and psychotropic medication and the development of suicidal tendencies is very complex, which ultimately also has an effect on the opportunities of suicide prevention in addiction disorders.
-
Literatur
- 1 World Health Organization. Suicide prevention: A global imperative. In: http://www who int/mental_health/suicide-prevention/world_report_2014/en/
- 2 Wilcox HC, Conner KR, Caine ED. Association of alcohol and drug use disorders and completed suicide: an empirical review of cohort studies. Drug and Alcohol Dependence 2004; 76 Suppl S11-S19 doi: 10.1016/j.drugalcdep.2004.08.003
- 3 Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997; 170: 205-228
- 4 Cavanagh JT, Carson AJ, Sharpe M. et al. Psychological autopsy studies of suicide: a systematic review. Psychol Med 2003; 33: 395-405
- 5 Arsenault-Lapierre G, Kim C, Turecki G. Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry 2004; 4: 37. doi: 1471-244X-4-37
- 6 Schneider B. Substance use disorders and risk for completed suicide. Arch Suicide Res 2009; 13: 303-316 doi: 10.1080/13811110903263191
- 7 Weltgesundheitsorganisation. Global health risks: Mortality and burden of disease attributable to selected major risks. Genf: World Health Organisation; 2014
- 8 Statistisches Bundesamt Deutschland. Sterbefälle nach äußeren Ursachen und ihren Folgen (ab 1998) In 2019; http://www.gbe-bund.de/oowa921-install/servlet/oowa/aw92/dboowasys921.xwdevkit/xwd_init?gbe.isgbetol/xs_start_neu/&p_aid=i&p_aid=72980652&nummer=6&p_sprache=D&p_indsp=-&p_aid=87470402
- 9 Schmidtke A, Bille-Brahe U, DeLeo D. et al. Suicidal Behaviour in Europe: Results from the WHO/Euro Multicentre Study on Suicidal Behaviour. Göttingen: Hogrefe; 2002
- 10 Shneidman ES. Forward In: Cain AC. (Hrsg.) Survivors of suicide. Springfield, IL: CC Thomas; 1972: ix-xi
- 11 Berman AL. Estimating the population of survivors of suicide: seeking an evidence base. Suicide Life Threat Behav 2011; 41: 110-116 doi: 10.1111/j.1943-278X.2010.00009.x
- 12 UNODC United Nations Office on Drugs and Crime. Word Drug Report 2018. Wien: United Nations publication; 2018
- 13 Gomes de Mateo E, Atzendorf J, Kraus L. et al. Substanzkonsum in der Allgemeinbevölkerung in Deutschland. Ergebnisse des Epidemiologischen Suchtsurveys 2015. Sucht 2016; 62: 271-281 doi: 10.1024/0939-5911/a000445
- 14 Kraus L, Atzendorf J, Schiele C. et al. Substanzbezogene Störungen. Ein gesellschaftliches Problem. Kerbe – Forum für soziale Psychiatrie 2019; 37: 9-12
- 15 Backmund M, Schutz CG, Meyer K. et al. Alcohol consumption in heroin users, methadone-substituted and codeine-substituted patients--frequency and correlates of use. Eur Addict Res 2003; 9: 45-50 doi: 10.1159/000067733
- 16 Wetterling T, Kugler C. Ältere Suchtkranke im psychiatrischen Krankenhaus. Z Gerontopsychol Psychiat 2006; 19: 195-200
- 17 CDC Center for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes – United States. Atlanta, Georgia: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2018
- 18 Schneider B, Wetterling T. Sucht und Suizidalität. Stuttgart: Kohlhammer; 2015
- 19 Schneider B. Risikofaktoren für Suizid. Regensburg: Roderer; 2003
- 20 Nordentoft M, Mortensen PB, Pedersen CB. Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry 2011; 68: 1058-1064. doi:10.1001/archgenpsychiatry.2011.113
- 21 Pirkola SP, Isometsä ET, Heikkinen ME. et al. Female psychoactive substance-dependent suicide victims differ from male – results from a nationwide psychological autopsy study. Compr Psychiatry 1999; 40: 101-107 doi: S0010-440X(99)90113-X
- 22 Pirkola S. Alcohol and other substance misuse in suicide. Academic dissertation 1999
- 23 Lee CT, Chen VC, Tan HK. et al. Suicide and other-cause mortality among heroin users in Taiwan: a prospective study. Addict Behav 2013; 38: 2619-2623. doi:10.1016/j.addbeh.2013.03.003
- 24 Darke S, Ross J. Suicide among heroin users: rates, risk factors and methods. Addiction 2002; 97: 1383-1394
- 25 Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997; 170: 205-228
- 26 Petit A, Reynaud M, Lejoyeux M. et al. Addiction à la cocaïne: un facteur de risque de suicide [Addiction to cocaine: a risk factor for suicide?]. Presse Med 2012; 41: 702-712. doi:10.1016/j.lpm.2011.12.006
- 27 Kittirattanapaiboon P, Suttajit S, Junsirimongkol B. et al. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders. Neuropsychiatr Dis Treat 2014; 10: 453-458 doi:10.2147/NDT.S56441
- 28 Arendt M, Munk-Jorgensen P, Sher L. et al. Mortality following treatment for cannabis use disorders: predictors and causes. J Subst Abuse Treat 2013; 44: 400-406 doi:10.1016/j.jsat.2012.09.007
- 29 Andreasson S, Allebeck P. Cannabis and mortality among young men: A longitudinal study of Swedish conscripts. Scand J Soc Med 1990; 18: 9-15
- 30 Price C, Hemmingsson T, Lewis G. et al. Cannabis and suicide: longitudinal study. Br J Psychiatry 2009; 195: 492-497 doi:10.1192/bjp.bp.109.065227
- 31 Bernard JP, Havnes I, Slordal L. et al. Methadone-related deaths in Norway. Forensic Sci Int 2013; 224: 111-116 doi:10.1016/j.forsciint.2012.11.010
- 32 Voaklander DC, Rowe BH, Dryden DM. et al. Medical illness, medication use and suicide in seniors: a population-based case-control study. J Epidemiol Community Health 2008; 62: 138-146. doi:10.1136/jech.2006.055533
- 33 Cheng AT. Mental illness and suicide. A case-control study in east Taiwan. Arch Gen Psychiatry 1995; 52: 594-603
- 34 Isometsä ET, Henriksson MM, Heikkinen ME. et al. Suicide among subjects with personality disorders. Am J Psychiatry 1996; 153: 667-673
- 35 Conwell Y, Duberstein PR, Cox C. et al. Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J Psychiatry 1996; 153: 1001-1008
- 36 Cheng AT, Mann AH, Chan KA. Personality disorder and suicide. A case-control study. Br J Psychiatry 1997; 170: 441-446
- 37 Brent DA, Perper JA, Moritz G. et al. Psychiatric risk factors for adolescent suicide: a case-control study. J Am Acad Child Adolesc Psychiatry 1993; 32: 521-529 doi:10.1097/00004583-199305000-00006
- 38 Wines Jr. JD, Saitz R, Horton NJ. et al. Suicidal behavior, drug use and depressive symptoms after detoxification: a 2-year prospective study. Drug Alcohol Depend 2004; 76 Suppl S21-S29 doi:10.1016/j.drugalcdep.2004.08.004
- 39 Wang LJ, Chiang SC, Su LW. et al. Factors associated with drug-related psychiatric disorders and suicide attempts among illicit drug users in Taiwan. Subst Use Misuse 2012; 47: 1185-1188 doi:10.3109/10826084.2012.690812
- 40 Maloney E, Degenhardt L, Darke S. et al. Suicidal behaviour and associated risk factors among opioid-dependent individuals: a case-control study. Addiction 2007; 102: 1933-1941 doi: 10.1111/j.1360-0443.2007.01971.x
- 41 Wong SS, Zhou B, Goebert D. et al. The risk of adolescent suicide across patterns of drug use: a nationally representative study of high school students in the United States from 1999 to 2009. Soc Psychiatry Psychiatr Epidemiol 2013; 48: 1611-1620 doi: 10.1007/s00127-013-0721-z
- 42 Darke S, Ross J, Marel C. et al. Patterns and correlates of attempted suicide amongst heroin users: 11-year follow-up of the Australian treatment outcome study cohort. Psychiatry Res 2015; 227: 166-170 doi: 10.1016/j.psychres.2015.04.010
- 43 Trémeau F, Darreye A, Staner L. et al. Suicidality in opioid-dependent subjects. Am J Addict 2008; 17: 187-194. doi: 10.1080/10550490802020160
- 44 Maloney E, Degenhardt L, Darke S. et al. Impulsivity and borderline personality as risk factors for suicide attempts among opioid-dependent individuals. Psychiatry Res 2009; 169: 16-21 doi:10.1016/j.psychres.2008.06.026
- 45 Noori R, Rafiey H, Azizabadi-Farahani M. et al. Risk factors of suicidal ideation and attempt in women with drug user spouses. J Chin Med Assoc 2013; 76: 648-652. doi: 10.1016/j.jcma.2013.07.003
- 46 Ashrafioun L, Bishop TM, Conner KR. et al. Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts. J Psychiatr Res 2017; 92: 1-7. doi: 10.1016/j.jpsychires.2017.03.011
- 47 Baiden P, Graaf G, Zaami M. et al. Examining the association between prescription opioid misuse and suicidal behaviors among adolescent high school students in the United States. J Psychiatr Res 2019; 112: 44-51 doi: 10.1016/j.jpsychires.2019.02.018
- 48 Pedersen W. Does cannabis use lead to depression and suicidal behaviours? A population-based longitudinal study. Acta Psychiatr Scand 2008; 118: 395-403. doi: 10.1111/j.1600-0447.2008.01259.x
- 49 Rasic D, Weerasinghe S, Asbridge M. et al. Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students. Drug Alcohol Depend 2013; 129: 49-53 doi: 10.1016/j.drugalcdep.2012.09.009
- 50 Borges G, Benjet C, Orozco R. et al. Alcohol, cannabis and other drugs and subsequent suicide ideation and attempt among young Mexicans. J Psychiatr Res 2017; 91: 74-82. doi: 10.1016/j.jpsychires.2017.02.025
- 51 Choi NG, DiNitto DM, Marti CN. et al. Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults. Int Psychogeriatr 2016; 28: 577-589. doi: 10.1017/S1041610215001738
- 52 Glasner-Edwards S, Mooney LJ, Marinelli-Casey P. et al. Risk factors for suicide attempts in methamphetamine-dependent patients. Am J Addict 2008; 17: 24-27. doi: 10.1080/10550490701756070
- 53 Marshall BD, Galea S, Wood E. et al. Injection methamphetamine use is associated with an increased risk of attempted suicide: a prospective cohort study. Drug Alcohol Depend 2011; 119: 134-137 doi: 10.1016/j.drugalcdep.2011.05.012
- 54 Schepis TS, McCabe SE. Prescription Tranquilizer/Sedative Sources for Misuse in Older Adults. Subst Use Misuse 2019; DOI: 10.1080/10826084.2019.1613434.
- 55 Wetterling T, Schneider B. Medikamentenmissbrauch bei älteren psychiatrischen Patienten [Prescription drug abuse in elderly psychiatric patients]. Psychiatr Prax 2012; 39: 275-279 doi: 10.1055/s-0032-1305043
- 56 Hilts KE, Greene M. Mental Health, Substance Misuse, and Suicide: Shared Risk and Protective Factors. Indianapolis, IN: The Center for Health Policy at the IU Richard M. Fairbanks School of Public Health; 2018. DOI: http://hdl.handle.net/1805/16542
- 57 Hufford MR. Alcohol and suicidal behavior. Clin Psychol Rev 2001; 21: 797-811 doi:S0272-7358(00)00070-2 [pii]
- 58 Carretta CM, Burgess AW, Dowdell EB. et al. Adolescent suicide cases: Toxicology reports and prescription drugs. J Nurse Practitioners 2018; 14: 552-558