TY - JOUR

T1 - Association between substance-induced psychosis and suicide attempt

T2 - A Danish nation-wide register-based study

AU - Munch, Solvejg Dam

AU - Madsen, Trine

AU - Nordentoft, Merete

AU - Erlangsen, Annette

AU - Hjorthøj, Carsten

N1 - Publisher Copyright: © 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

PY - 2023

Y1 - 2023

N2 - Background and aims: Substance-induced psychosis has previously been linked to an excess risk of suicide; however, the association between substance-induced psychosis and suicide attempt has hitherto not been investigated. We investigated whether substance-induced psychosis was associated with a higher risk of subsequent suicide attempt. Design: Nation-wide prospective register-based cohort study. Setting: Denmark. Participants: All people living in Denmark aged 13 years or more during 1995 to 2017. Measurements: Substance-induced psychosis and suicide attempts were identified through hospital records as ICD-10 codes. Findings: A total of 8900 (78.8% males) individuals were diagnosed with a substance-induced psychosis, and 740 of these had a suicide attempt during follow-up. People with a substance-induced psychosis had a higher risk of a subsequent suicide attempt [hazard ratio (HR) = 13.4, 95% confidence interval (CI) = 12.4–14.4] when compared with the general population. The highest hazard ratios were found for psychosis induced by opioids (HR = 26.4, 95% CI = 18.2–38.2); alcohol (HR = 17.7, 95% CI = 15.2–20.6); sedatives (HR = 17.2, 95% CI = 8.9–33.0); and cocaine (HR = 15.6, 95% CI = 10.7–22.8), while cannabis-induced psychosis was linked to an HR of 8.9 (95% CI = 7.7–10.3). Approximately 15% of patients with substance-induced psychosis had had a suicide attempt within 20 years of their substance-induced psychosis diagnosis. Conclusions: In Denmark, substance-induced psychosis appears to be strongly associated with subsequent suicide attempt, underscoring the importance of attention and better follow-up for this patient group.

AB - Background and aims: Substance-induced psychosis has previously been linked to an excess risk of suicide; however, the association between substance-induced psychosis and suicide attempt has hitherto not been investigated. We investigated whether substance-induced psychosis was associated with a higher risk of subsequent suicide attempt. Design: Nation-wide prospective register-based cohort study. Setting: Denmark. Participants: All people living in Denmark aged 13 years or more during 1995 to 2017. Measurements: Substance-induced psychosis and suicide attempts were identified through hospital records as ICD-10 codes. Findings: A total of 8900 (78.8% males) individuals were diagnosed with a substance-induced psychosis, and 740 of these had a suicide attempt during follow-up. People with a substance-induced psychosis had a higher risk of a subsequent suicide attempt [hazard ratio (HR) = 13.4, 95% confidence interval (CI) = 12.4–14.4] when compared with the general population. The highest hazard ratios were found for psychosis induced by opioids (HR = 26.4, 95% CI = 18.2–38.2); alcohol (HR = 17.7, 95% CI = 15.2–20.6); sedatives (HR = 17.2, 95% CI = 8.9–33.0); and cocaine (HR = 15.6, 95% CI = 10.7–22.8), while cannabis-induced psychosis was linked to an HR of 8.9 (95% CI = 7.7–10.3). Approximately 15% of patients with substance-induced psychosis had had a suicide attempt within 20 years of their substance-induced psychosis diagnosis. Conclusions: In Denmark, substance-induced psychosis appears to be strongly associated with subsequent suicide attempt, underscoring the importance of attention and better follow-up for this patient group.

KW - cannabis

KW - epidemiology

KW - self-harm

KW - substance use disorder

KW - substance-induced psychosis

KW - suicide attempt

U2 - 10.1111/add.16311

DO - 10.1111/add.16311

M3 - Journal article

C2 - 37574563

AN - SCOPUS:85167972450

VL - 118

SP - 2440

EP - 2448

JO - Addiction

JF - Addiction

SN - 0965-2140

IS - 12

ER -