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Smoking differently modifies suicide risk of affective disorders, substance use disorders, and social factors.
J Affect Disord. 2009 Jan; 112(1-3):165-73.JA

Abstract

BACKGROUND

Although an association between smoking and suicide has repeatedly been shown, information about a modifying influence of smoking on other risk factors for suicide is lacking.

METHODS

Axis I and Axis II disorders, sociodemographic factors, and tobacco use were assessed by a semi-structured interview including the Structured Clinical Interview for DSM-IV Axis I (SCID-I) and Personality Disorders (SCID-II) in 163 suicides (mean age 49.6+/-19.3 years; 64.4% men;) by psychological autopsy method and by personal interview in 396 living population-based control persons (mean age 51.6+/-17.0 years; 55.8% men).

RESULTS

Smoking status (current smokers, lifetime non-smokers, and former smokers) differently modifies the effects of psychiatric disorders and sociodemographic variables on suicide risk. Former and current smoking modified suicide risk associated with affective disorders, but only current smoking increased suicide risk for substance use disorders. Ex-smokers with affective disorders, particularly with major depression, had less increased suicide risk than current smokers and non-smokers with affective disorders. Estimated suicide risks for personality disorders and 'no professional training' were strongly increased by smoking.

LIMITATIONS

Due to the small size of some of the subgroups, confidence intervals are wide. Therefore, precise risk estimation is not possible.

CONCLUSIONS

Clinicians should interpret smoking as an indicator of increased risk of suicide for individuals with substance use disorders, personality disorders, and adverse social factors. Further studies are needed to investigate the effects of smoking cessation on suicide risk of patients with psychiatric disorders such as major depression and substance use disorders.

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Authors+Show Affiliations

Schneider B
Centre of Psychiatry, Department of Psychiatry, Psychosomatics, and Psychotherapy, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. B.Schneider@em.uni-frankfurt.de
Wetterling T
No affiliation info available
Georgi K
No affiliation info available
Bartusch B
No affiliation info available
Schnabel A
No affiliation info available
Blettner M
No affiliation info available

MeSH

Case-Control StudiesComorbidityControl GroupsDepressive Disorder, MajorDiagnostic and Statistical Manual of Mental DisordersFemaleGermanyHumansMaleMiddle AgedMood DisordersPersonality DisordersPrevalencePsychiatric Status Rating ScalesResearchRisk FactorsSmokingSmoking CessationSocioeconomic FactorsSubstance-Related DisordersSuicide

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18558438

Citation

Schneider, Barbara, et al. "Smoking Differently Modifies Suicide Risk of Affective Disorders, Substance Use Disorders, and Social Factors." Journal of Affective Disorders, vol. 112, no. 1-3, 2009, pp. 165-73.
Schneider B, Wetterling T, Georgi K, et al. Smoking differently modifies suicide risk of affective disorders, substance use disorders, and social factors. J Affect Disord. 2009;112(1-3):165-73.
Schneider, B., Wetterling, T., Georgi, K., Bartusch, B., Schnabel, A., & Blettner, M. (2009). Smoking differently modifies suicide risk of affective disorders, substance use disorders, and social factors. Journal of Affective Disorders, 112(1-3), 165-73. https://doi.org/10.1016/j.jad.2008.04.018
Schneider B, et al. Smoking Differently Modifies Suicide Risk of Affective Disorders, Substance Use Disorders, and Social Factors. J Affect Disord. 2009;112(1-3):165-73. PubMed PMID: 18558438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking differently modifies suicide risk of affective disorders, substance use disorders, and social factors. AU - Schneider,Barbara, AU - Wetterling,Tilman, AU - Georgi,Klaus, AU - Bartusch,Bernadette, AU - Schnabel,Axel, AU - Blettner,Maria, Y1 - 2008/06/16/ PY - 2008/03/05/received PY - 2008/04/23/revised PY - 2008/04/23/accepted PY - 2008/6/19/pubmed PY - 2009/5/28/medline PY - 2008/6/19/entrez SP - 165 EP - 73 JF - Journal of affective disorders JO - J Affect Disord VL - 112 IS - 1-3 N2 - BACKGROUND: Although an association between smoking and suicide has repeatedly been shown, information about a modifying influence of smoking on other risk factors for suicide is lacking. METHODS: Axis I and Axis II disorders, sociodemographic factors, and tobacco use were assessed by a semi-structured interview including the Structured Clinical Interview for DSM-IV Axis I (SCID-I) and Personality Disorders (SCID-II) in 163 suicides (mean age 49.6+/-19.3 years; 64.4% men;) by psychological autopsy method and by personal interview in 396 living population-based control persons (mean age 51.6+/-17.0 years; 55.8% men). RESULTS: Smoking status (current smokers, lifetime non-smokers, and former smokers) differently modifies the effects of psychiatric disorders and sociodemographic variables on suicide risk. Former and current smoking modified suicide risk associated with affective disorders, but only current smoking increased suicide risk for substance use disorders. Ex-smokers with affective disorders, particularly with major depression, had less increased suicide risk than current smokers and non-smokers with affective disorders. Estimated suicide risks for personality disorders and 'no professional training' were strongly increased by smoking. LIMITATIONS: Due to the small size of some of the subgroups, confidence intervals are wide. Therefore, precise risk estimation is not possible. CONCLUSIONS: Clinicians should interpret smoking as an indicator of increased risk of suicide for individuals with substance use disorders, personality disorders, and adverse social factors. Further studies are needed to investigate the effects of smoking cessation on suicide risk of patients with psychiatric disorders such as major depression and substance use disorders. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/18558438/Smoking_differently_modifies_suicide_risk_of_affective_disorders_substance_use_disorders_and_social_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(08)00187-0 DB - PRIME DP - Unbound Medicine ER -