Association between substance-induced psychosis and suicide attempt: A Danish nation-wide register-based study

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 subsequen...

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Published in:Addiction (Abingdon, England) England), 2023-12, Vol.118 (12), p.2440-2448
Main Authors: Munch, Solvejg Dam, Madsen, Trine, Nordentoft, Merete, Erlangsen, Annette, Hjorthøj, Carsten
Format: Article
Language:English
Subjects:
Cannabis
Cocaine
Cohort analysis
Drug abuse
Induced
Males
Marijuana
Medical diagnosis
Opioids
Psychosis
Sedative drugs
Sedatives
Suicide
Suicides & suicide attempts
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Summary: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. Nation-wide prospective register-based cohort study. Denmark. All people living in Denmark aged 13 years or more during 1995 to 2017. Substance-induced psychosis and suicide attempts were identified through hospital records as ICD-10 codes. 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. 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.
ISSN:0965-2140
1360-0443
DOI:10.1111/add.16311