Palavras-chave
Child-Abuse
Self-injurious-Behavior
Substance-Related-Disorders
Suicide
Experiencias-Adversas-de-la-Infancia
Conducta-Autodestructiva
Maltrato-a-los-Niños
Suicidio
Trastornos-Relacionados-con-Sustancias
Experiências-Adversas-da-Infância
Comportamento-Autodestrutivo
Maus-Tratos-Infantis
Suicídio
Transtornos-Relacionados-ao-Uso-de-Substâncias
Como Citar
Resumo
Introdução: O uso abusivo de substâncias psicoativas é considerado um fator social problemático quando ocorrem comportamentos autodestrutivos prejudiciais ao sujeito e à sociedade. O estresse no início da vida de um indivíduo também pode ser um fator que contribui para situações de abuso de substâncias, bem como tentativas de suicídio. Há uma falta de estudos examinando esses fatores em pessoas com transtorno por uso de substâncias.
Objetivo: Identificar a relação entre o estresse no início da vida e as tentativas de suicídio em adultos com transtorno de uso de substâncias.
Métodos: Estudo correlacional preditivo com abordagem transversal. A amostra por conveniência foi composta por 105 indivíduos atendidos em uma unidade ambulatorial para tratamento de dependências e foi avaliada por meio do Mini-International Neuropsychiatric Interview, do Childhood Trauma Questionnaire para medir a gravidade de diferentes tipos de estresse precoce e da Escala de Beck para Ideação Suicida. Os dados foram analisados por meio de estatística descritiva e inferencial por meio de regressão logística univariada e multivariada.
Resultados: Da amostra analisada, 33 (31,4%) já haviam tentado suicídio e tiveram exposição significativamente maior a abusos emocionais, físicos e sexuais (p <0,05) em comparação com os participantes que nunca tentaram suicídio.
Conclusões: Diferentes formas de estresse no início da vida estão relacionadas à tentativa de suicídio em indivíduos com transtorno por uso de substâncias . Mais estudos são necessários para compreender os efeitos do estresse precoce nas tentativas de suicídio de uma pessoa com dependência.
Referências
United Nations Office on Drugs and Crime. World Drug Report 2020 [Internet]. United Nations; 2020 [cited 2021 Oct 13]. Available from: https://www.un-ilibrary.org/content/books/9789210050470/read
Fundação Oswaldo Cruz, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. III Levantamento Nacional sobre o uso de drogas pela população brasileira [Internet]. 2017 [cited 2021 Feb 23]; Available from: https://www.arca.fiocruz.br/handle/icict/34614
Kim BKE, Gilman AB, Kosterman R, Hill KG. Longitudinal associations among depression, substance abuse, and crime: A test of competing hypotheses for driving mechanisms. J Crim Justice. 2019;62:50–7. doi: https://doi.org/10.1016/j.jcrimjus.2018.08.005
Too LS, Spittal MJ, Bugeja L, Reifels L, Butterworth P, Pirkis J. The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies. J Affect Disord. 2019;259:302–13. doi: https://doi.org/10.1016/j.jad.2019.08.054
Padmanathan P, Hall K, Moran P, Jones HE, Gunnell D, Carlisle V, et al. Prevention of suicide and reduction of self-harm among people with substance use disorder: A systematic review and meta-analysis of randomised controlled trials. Compr Psychiatry. 2020;96:152135. doi: https://doi.org/10.1016/j.comppsych.2019.152135
Jung M. The relationship between alcohol abuse and suicide risk according to smoking status: A cross-sectional study. J Affect Disord. 2019;244:164–70. doi: https://doi.org/10.1016/j.jad.2018.09.077
Bonadiman CSC, Passos VMA, Mooney M, Naghavi M, Melo APS. A carga dos transtornos mentais e decorrentes do uso de substâncias psicoativas no Brasil: Estudo de Carga Global de Doença, 1990 e 2015. Rev Bras Epidemiol [Internet]. 2017;20:191–204. doi: https://doi.org/10.1590/1980-5497201700050016
Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, Harris MG, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: Findings from the Global Burden of Disease Study 2010. PLoS One [Internet]. 2014;9(4). doi: 10.1371/journal.pone.0091936
Kinsella EA, Smith K, Bhanji S, Shepley R, Modor A, Bertrim A. Mindfulness in allied health and social care professional education: a scoping review. Disabil Rehabil. 2020;42(2):283–95. doi: https://doi.org/10.1080/09638288.2018.1496150
Ostergaard MLD, Nordentoft M, Hjorthoj C. Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nation-wide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder. Addiction. 2017;112(7):1250–9. doi: https://doi.org/10.1111/add.13788
Enoch MA. The role of early life stress as a predictor for alcohol and drug dependence. Psychopharmacology (Berl). 2011 Mar;214(1):17–31. Doi:10.1007/s00213-010-1916-6.
Fuller-Thomson E, Roane JL, Brennenstuhl S. Three Types of Adverse Childhood Experiences, and Alcohol and Drug Dependence Among Adults: An Investigation Using Population-Based Data. Subst Use Misuse. 2016;51(11):1451–61. doi: https://doi.org/10.1080/10826084.2016.1181089
Choi NG, DiNitto DM, Marti CN, Segal SP. Adverse childhood experiences and suicide attempts among those with mental and substance use disorders. Child Abus Negl. 2017;69:252–62. doi: https://doi.org/10.1016/j.chiabu.2017.04.024
Hung GCL, Caine ED, Fan HF, Huang MC, Chen YY. Predicting suicide attempts among treatment-seeking male alcoholics: An exploratory study. Suicide Life-Threatening Behav. 2013;43(4):429–38. doi: https://doi.org/10.1111/sltb.12028
Marshall BDL, Galea S, Wood E, Kerr T. Longitudinal associations between types of childhood trauma and suicidal behavior among substance users: A cohort study. Am J Public Health. 2013;103(9):e69. doi: https://doi.org/10.2105/AJPH.2013.301257
Angelakis I, Gillespie EL, Panagioti M. Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychol Med. 2019;49(7):1057–78. doi: https://doi.org/10.1017/S0033291718003823
Newins AR, Wilson LC, Kimbrel NA. Child maltreatment and suicidal ideation: The role of PTSD symptoms and alcohol misuse. Curr Psychol. 2019;1–7. doi: https://doi.org/10.1007/s12144-019-00436-1
Mohammadzadeh A, Ganji Z, Khosravani V, Mohammadpanah Ardakan A, Amirinezhad A. Direct and indirect associations between perception of childhood trauma and suicidal ideation through emotion dysregulation in males who use heroin. Addict Behav. 2019;98:106011. doi: https://doi.org/10.1016/j.addbeh.2019.05.035
Icick R, Karsinti E, Brousse G, Chrétienneau C, Trabut J-B, Belforte B, et al. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Subst Abus. 2021;1–10. doi: https://doi.org/10.1080/08897077.2021.1975875
Amorim P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr. 2000;22(3):106–15. doi: https://doi.org/10.1590/S1516-44462000000300003
Marques JMA, Zuardi AW. Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil. Gen Hosp Psychiatry. 2008;30(4):303–10. doi: https://doi.org/10.1016/j.genhosppsych.2008.02.001
Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abus Negl. 2003;27(2):169–90. doi: https://doi.org/10.1016/j.genhosppsych.2008.02.001
Grassi-Oliveira R, Stein LM, Pezzi JC. Tradução e validação de conteúdo da versão em português do Childhood Trauma Questionnaire. Rev Saude Publica. 2006;40(2):249–55. doi: https://doi.org/10.1590/S0034-89102006000200010
Cunha J. Manual da versão em português das Escalas Beck – ScienceOpen [Internet]. São Paulo: Casa do Psicólogo; 2001 [cited 2021 Feb 24]. Available from: https://www.scienceopen.com/document?vid=760d7977-aa5a-4b16-be6a-7f84e0aa0201
Werlang BSG, Borges VR, Fensterseifer L. Estudo de fidedignidade e validade da Escala de Ideação Suicida de Beck. In: Comportamento suicida. Porto Alegre: Artmed; 2004:189–93.
Jordans M, Rathod S, Fekadu A, Medhin G, Kigozi F, Kohrt B, et al. Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: A cross-sectional study. Epidemiol Psychiatr Sci. 2018;27(4):393–402. doi: https://doi.org/10.1017/S2045796017000038
Plans L, Nieto E, Benabarre A, Vieta E. Completed suicide in bipolar disorder patients: A cohort study after first hospitalization. J Affect Disord. 2019;257:340–4. doi: https://doi.org/10.1016/j.jad.2019.07.048
Borges G, Nock MK, Abad JMH, Hwang I, Sampson NA, Alonso J, et al. Twelve-month prevalence of and risk factors for suicide attempts in the world health organization world mental health surveys. J Clin Psychiatry. 2010;71(12):1617–28 doi: 10.4088/JCP.08m04967blu
Abdalla RR, Miguel AC, Brietzke E, Caetano R, Laranjeira R, Madruga CS. Suicidal behavior among substance users: Data from the second brazilian national alcohol and drug survey (II bnads). Brazilian J Psychiatry. 2019;41(5):437–40. doi: https://doi.org/10.1590/1516-4446-2018-0054
Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016;387(10024):1227–39. doi: https://doi.org/10.1016/S0140-6736(15)00234-2
Vijayakumar L. Suicide in women. Indian J Psychiatry. 2015;57(6):233. doi: 10.4103/0019-5545.161484
Alvarado-Esquivel C. Suicidal Ideation and Suicide Attempts in Middle-Aged Women Attending a Primary Care Center: A Cross-Sectional Study in Mexico. J Clin Med Res. 2018;10(9):693–9. doi: https://doi.org/10.14740/jocmr3501w
Park S, Lee Y, Youn T, Kim BS, Park JI, Kim H, et al. Association between level of suicide risk, characteristics of suicide attempts, and mental disorders among suicide attempters. BMC Public Health. 2018;18(1). doi: https://doi.org/10.1186/s12889-018-5387-8
Fountoulakis KN. Suicides in Greece before and during the period of austerity by sex and age group: Relationship to unemployment and economic variables. J Affect Disord. 2020;260:174–82. doi: https://doi.org/10.1016/j.jad.2019.09.001
Goodwill JR, Zhou S. Association between perceived public stigma and suicidal behaviors among college students of color in the U.S. J Affect Disord. 2020;262:1–7. doi: https://doi.org/10.1016/j.jad.2019.10.019
Yuodelis-Flores C, Ries RK. Addiction and suicide: A review. Am J Addict. 2015;24:98–104. doi: https://doi.org/10.1111/ajad.12185
Liu J, Fang Y, Gong J, Cui X, Meng T, Xiao B, et al. Associations between suicidal behavior and childhood abuse and neglect: A meta-analysis. J Affect Disord. 2017;220:147–55. doi: https://doi.org/10.1016/j.jad.2017.03.060
Rodríguez-Cintas L, Daigre C, Braquehais MD, Palma-Alvarez RF, Grau-López L, Ros-Cucurull E, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res. 2018;262:440–5. doi: https://doi.org/10.1016/j.psychres.2017.09.021
Heim C, Shugart M, Craighead WE, Nemeroff CB. Neurobiological and psychiatric consequences of child abuse and neglect. Dev Psychobiol. 2010;52(7):671–90. doi: https://doi.org/10.1002/dev.20494
Lee Y, Lee D, Hong HJ. Gender-based Multilevel Analysis of Influential Factors for Suicide Attempts among At-risk Non-referred Adolescents in Korea. Clin Psychopharmacol Neurosci. 2020;18(1):116–26. doi: https://doi.org/10.9758/cpn.2020.18.1.116
Comentários
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2023 Elton Brás Camargo-Júnior, Dr., Maria Neyrian de Fátima Fernandes, Edilaine Cristina da Silva Gherardi-Donato, Dra