Heroin-dependent patients attempting and not attempting suicide: a comparison
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Objective: Heroin dependence is a serious illness associated with an increased risk of suicidal behaviour. There are many risk factors associated with heroin dependence. The current study examined the sociodemographic and clinical characteristics of a number of young adult heroin-dependent patients who had attempted suicide. Methods: We studied a group of 108 young adult heroin-dependent patients in our in-patient clinics. All diagnoses were made according to DSM-IV diagnostic criteria using the Structured Clinical Interview for DSM-IV Axis I-II Disorders (SCID-I, II). The age range of patients was 18-24 years. Their substance abuse histories were assessed by semistructured interview. The Addiction Severity Index (ASI) was administered to all the patients. Serum total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels were routinely measured. In the statistical analyses, Student's t test, and chi-squared tests were applied. Results: Of the 108 heroin-dependent patients, 40 ( 37.0%) had histories of attempted suicide. There was a statistically significant difference in the age at which heroin use had commenced between female attempters [ mean = 16.82, standard deviation ( SD) = 3.06] and nonattempters ( mean = 18.32, SD = 2.68, t = 2.25, P < 0.05). Both the male ( mean 33.35, SD = 4.05) and the female ( mean = 28.00, SD = 5.36) attempters had significantly higher ASI scores than did the male ( mean = 20.16, SD = 3.80) and the female ( mean = 18.88, SD = 4.14) nonattempters ( t = 14.34, P < 0.001; t = 5.25, P < 0.001, respectively). A significant difference in total cholesterol ( mean = 131.8, SD = 19.3; mean = 172.2, SD = 21.3, t = 3.9, P < 0.05) and HDL-C ( mean = 30.9, SD = 1.0 and mean = 54.8, SD = 13.7; t = 5.1, P < 0.05) levels between the group of violent and nonviolent suicide attempters was revealed. Conclusions: These results suggest that suicide attempts in young adult heroin-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels. In particular, low levels of total cholesterol and HDL-C might indeed be associated with violent suicide attempts in young heroin-dependent patients.