Alcohol and substance use differentially impact suicidal ideation in a longitudinal cohort of bipolar disorder

IF 4.2 2区医学 Q1 PSYCHIATRY Psychiatry Research Pub Date : 2025-02-01 DOI:10.1016/j.psychres.2025.116357

Julia L. Smith, Melvin G. McInnis, Sarah H. Sperry

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Abstract

Background

Across bipolar disorders (BSDs), alcohol and substance use and suicidal ideation (SI) contribute to increased rates of morbidity and mortality. The goal of the present study was to investigate temporal relationships between the intensity/frequency (I/F) of use and impairment related to alcohol and substance use and SI in a longitudinal BSD cohort.

Methods

Participants with BDI (n=565), BDII (n=162), and BD NOS (n=61) were included (median enrollment=72 months). Alcohol and substance use were measured using a modified version of the AUDIT administered every 6 months. SI was measured every 2 months using item 9 from the PHQ-9. Linear mixed effects models tested concurrent associations and Dynamic Structural Equation Models tested prospective associations between alcohol and substance use I/F and impairment with SI.

Results

Cocaine I/F and alcohol and substance use impairment were concurrently associated with SI. When a person had more frequent and intense cannabis use compared to average, they had higher SI at the next timepoint. When individuals experienced more alcohol and substance use impairment than average, they had higher SI at the next timepoint.

Conclusions

I/F of cannabis use and alcohol and substance use impairment appear to lead to future increases in SI for those with BSDs.

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在双相情感障碍纵向队列中，酒精和物质使用对自杀意念的影响存在差异。

背景：在双相情感障碍（bsd）中，酒精和物质使用以及自杀意念（SI）导致发病率和死亡率增加。本研究的目的是在纵向BSD队列中调查使用强度/频率（I/F）与酒精和物质使用和SI相关的损害之间的时间关系。方法：纳入BDI （n=565）、BDII （n=162）和bdnos （n=61）患者（中位入组时间为72个月）。使用每6个月一次的修订版审计来测量酒精和物质使用情况。使用PHQ-9中的第9项每2个月测量一次SI。线性混合效应模型测试了并发关联，动态结构方程模型测试了酒精和物质使用I/F和SI损伤之间的前瞻性关联。结果：可卡因I/F、酒精和物质使用障碍与SI同时相关。当一个人使用大麻的频率和强度高于平均水平时，他们在下一个时间点的SI更高。当个体经历比平均水平更多的酒精和物质使用障碍时，他们在下一个时间点的SI更高。结论：大麻使用、酒精和物质使用障碍的I/F似乎会导致bsd患者未来SI的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatry Research 医学-精神病学

CiteScore

17.40

自引率

1.80%

发文量

527

审稿时长

57 days

期刊介绍： Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry. The scope of the journal encompasses: Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders. Diagnostic assessments of psychiatric disorders. Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases. Evaluations of pharmacologic and non-pharmacologic psychiatric treatments. Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders. Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.