Madde Kullanım Bozukluğu İle Hastaneye Yatırılan Hastalarda Depresyonun Şiddeti ve Algılanan Sosyal Desteğin İntihar Düşüncesi Üzerindeki Etkisi

Öz

Amaç: Çalışmamızda, madde kullanım bozukluğu nedeniyle yatan hastalarda algılanan sosyal desteğin ve çeşitli belirleyicilerinin intihar düşüncesini nasıl etkilediğini ve depresyon ile ilişkisini araştırmayı amaçladık. Yöntem: Çalışmaya Alkol Madde Tedavi Merkezinde yatarak tedavi gören 110 hasta dahil edilmiştir. Hastalara sosyodemografik ve klinik bilgi formu, Beck Depresyon Envanteri, İntihar Düşüncesi Ölçeği ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği uygulandı. Bulgular: Toplam sosyal destek puanı ile intihar düşüncesi arasında anlamlı bir korelasyon saptanmazken, aileden alınan sosyal destek ile intihar düşüncesi puanları arasında negatif yönde zayıf ancak istatistiksel olarak anlamlı bir korelasyon bulundu (r=-0.231; p=0.016). İntihar düşüncesi ortalama değeri depresyonda olmayan grupta 2,22 iken ağır depresyonda olan grupta 10,13'tür. Ayrıca, askerlikten muaf olan ve daha önce intihar girişiminde bulunmuş olan hastaların intihar düşüncesi ölçeğinden istatistiksel olarak anlamlı derecede daha yüksek puan aldıkları bulunmuştur. Sonuç: Madde kullanım bozukluğu tanısı almış hastalarda çeşitli faktörlerin intihar davranışını rislini arttırabilceği göz önünde bulundurulmalıdır. Özellikle sosyal desteği yetersiz, depresif semptomları olan, askerlik görevini yerine getiremeyen ve daha önce intihar girişiminde bulunmuş hastalar intihar düşüncesi açısından yakından takip edilmelidir..

Anahtar Kelimeler

• madde kullanım bozukluğu
• intihar düşüncesi,
• sosyal destek

Effect of Severity of Depression and Perceived Social Support on Suicidal Ideation among Patients Hospitalized with Substance Use Disorder

Öz

Objective: The aim of this study was to investigate the effects of perceived social support and depression on suicidal ideation in inpatients receiving substance abuse disorder treatment. Method: A total of 110 inpatients in an Alcohol and Drug Treatment Center were included in the study. A sociodemographic and clinical information form, Beck Depression Inventory, Suicidal Ideation Scale, and Multidimensional Perceived Social Support Scale were administered to all patients. Results: No significant correlation was identified between total social support score and suicidal ideation, whereas a weak negative but statistically significant correlation was found between social support from family and suicidal ideation scores (r=-0.231; p=0.016). The mean value of suicidal ideation was 2.22 in the non-depressed groupand 10.13 in the severely depressed group. We also found thatpatients whowere exempted from military service and those who had attempted suicide before had statistically significantly higher scores on the suicidal ideation scale. Conclusion: In patients diagnosed with substance use disorder, various factors may increase the risk of suicidal behavior. In particular, patients with insufficient social support, depressive symptoms, unable to carry out their military service and those who have attempted suicide before should be closely followed for suicidal ideation.

Anahtar Kelimeler

• substance use disorder
• suicidal ideation
• social support

Kaynakça

1. Mohamed II, Ahmad HE, Hassaan SH, Hassan SM. Assessment of anxiety and depression among substance use disorder patients: a case-control study. Middle East Curr Psychiatry 2020; 27: 20.
2. Armoon B, SoleimanvandiAzar N, Fleury MJ, et al. Prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among people with substance use disorders: a systematic review and meta-analysis. J Addict Dis 2021; 39(4): 550-569.
3. Restrepo D, Gutierrez-Ochoa N, Rodriguez-Echeverri C, Sierra-Hincapie G. Suicide risk associated with dual diagnosis in general population. Addict Disord Their Treat 2019; 18(2): 89-93.
4. Díaz-Morán S, Estanislau C, Ca T, et al. Relationships of open-field behaviour with anxiety in the elevated zero-maze test: Focus on freezing and grooming. World J Neurosci 2014; 4(1): 1-11.
5. Bohnert AS, Roeder K, Ilgen MA. Unintentional overdose and suicide among substance users: a review of overlap and risk factors. Drug Alcohol Depend 2010; 110(3): 183-192.
6. López-Goñi JJ, Fernández-Montalvo J, Arteaga A, Haro B. Suicidal ideation and attempts in patients who seek treatment for substance use disorder. Psychiatry Res 2018; 269: 542-548.
7. Rodríguez-Cintas L, Daigre C, Braquehais MD, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res 2018; 262: 440-445.
8. Coppersmith DD, Kleiman EM, Glenn CR, et al. The dynamics of social support among suicide attempters: A smartphone-based daily diary study. Behav Res Ther 2019; 120: 103348.

9. Walsh J, Boyle J. Improving acute psychiatric hospital services according to inpatient experiences. A user-led piece of research as a means to empowerment. Issues Ment Health Nurs 2009; 30(1): 31-38.
10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, DSM-5 (5th ed.). Washington, DC: American Psychiatric Association, 2013.
11. Altintas E, Ozlem Kutuk M, Tufan AE, Gozukara Bag H. Alexithymia is not a good predictor of suicidal ideation in patients with social anxiety disorder. Anadolu Psikiyatri Derg 2018; 19: 577–585.
12. Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4(6): 561-571.
13. Kılınç S, Torun F. Türkiye’de klinikte kullanılan depresyon değerlendirme ölçekleri. Dirim Tıp Gazetesi 2011; 86(1): 39-47.
14. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess 1988; 52(1): 30-41.
15. Eker D, Arkar H. Çok boyutlu algılanan sosyal destek ölçeğinin faktör yapısı, geçerlik ve güvenirliği. Türk Psikoloji Dergisi 1995; 10(34): 45-55.
16. Levine S, Ancill RU, Roberts AP. Assessment of suicide risk by computer‐delivered self‐rating questionnaire: preliminary findings. Acta Psychiatr Scand 1989; 80(3): 216-220.
17. Dilbaz N, Holat H, Bayam G, et al. Validity and reliability of suicide ideation scale. Scientific Studies Book of 31st Turkish National Congress of Psychiatry. Istanbul: TPD Press; 1995: 40-1.
18. Cobb S. Social support as a moderator of life stress. Psychosom Med 1976; 38(5): 300-314.
19. Heikkinen M, Aro H, Lönnqvist J. Recent life events, social support and suicide. Acta Psychiatr Scand 1994; 89 (Suppl 377): 65-72.
20. Rodríguez-Cintas L, Daigre C, Braquehais MD, et al. Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Res 2018; 262: 440-445.
21. Rubio A, Oyanedel JC, Cancino F, et al. Social support and substance use as moderators of the relationship between depressive symptoms and suicidal ideation in adolescents. Front Psychol 2020;11: 539165.
22. Deng Y, Li X, Liu L, Chui WH. Suicide attempts and perceived social support among Chinese drug users: The mediating role of self-esteem and depression. Int J Environ Res Public Health 2021; 18(1): 208.
23. Chou SP, Lee HK, Cho MJ, et al. Alcohol use disorders, nicotine dependence, and co-occurring mood and anxiety disorders in the United States and South Korea—A Cross-National Comparison. Alcohol Clin Exper Res 2012; 36(4): 654–662.
24. Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol use disorder. Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry 2015; 72(8): 757–766
25. Darke S, Ross J, Lynskey M, Teesson M. Attempted suicide among entrants to three treatment modalities for heroin dependence in the Australian Treatment Outcome Study (ATOS): prevalence and risk factors. Drug Alcohol Depend 2004; 73(1): 1-10.
26. Preuss UW, Schuckit MA, Smith TL, et al. Predictors and correlates of suicide attempts over 5 years in 1,237 alcohol-dependent men and women. Am.J Psychiatry 2003; 160(1): 56-63.
27. Onaemo VN, Fawehinmi TO, D’Arcy C. Risk of suicide ideation in comorbid substance use disorder and major depression. Plos One 2022; 17(12): e0265287.
28. Hawton K, Comabella CC, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. J Affect Disord 2013; 147(1-3): 17-28.
29. Hoge CW, Toboni HE, Messer SC, et al. The occupational burden of mental disorders in the US military: psychiatric hospitalizations, involuntary separations, and disability. Am J Psychiatry 2005; 162(3): 585-591.
30. Kessler RC, Borges G, Walters EE. Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Arch Gen Psychiatry 1999; 56(7): 617-626.
31. Goldney RD, Dal Grande E, Fisher LJ, Wilson D. Population attributable risk of major depression for suicidal ideation in a random and representative community sample. J Affect Disord 2003; 74(3): 267-272.
32. Inoue C, Shawler E, Jordan C, Jackson C. Veteran and Military Mental Health Issues. Treasure Island, FL: StatPearls Publishing, 2023.
33. Franklin JC, Ribeiro JD, Fox KR, et al. Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychol Bull 2017; 143(2): 187-232.
34. Kuo WH, Gallo JJ, Tien AY. Incidence of suicide ideation and attempts in adults: the 13-year follow-up of a community sample in Baltimore, Maryland. Psychol Med 2001; 31(7): 1181-1191.
35. Wichstrøm L. Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents. J Am Acad Child Adolesc Psychiatry 2000; 39(5): 603-610