Which Posttraumatic Stress Disorder Symptoms, Trauma Types, and Substances Correlate With Suicide Attempts in Trauma Survivors?

Prim Care Companion CNS Disord. 2017 Oct 26;19(5):17m02177. doi: 10.4088/PCC.17m02177.

Abstract

Objective: To examine among trauma survivors several potential suicide risk factors, some of which have never been studied in this population (eg, DSM-5 posttraumatic stress disorder [PTSD] symptoms, benzodiazepines).

Methods: Using a cross-sectional self-report survey methodology in a consecutive sample of adult outpatients with trauma (N = 480), we examined relationships between suicide attempts and demographics, trauma types, PTSD symptoms, substance-related problems, and benzodiazepine prescriptions. The study was conducted from October 2014 to February 2015.

Results: PTSD diagnosis was significantly correlated with suicide attempt prevalence (adjusted odds ratio [AOR] = 2.6) and was the variable most strongly associated with the number of attempts among participants with at least 1 suicide attempt. PTSD symptom severities (total, cluster, and all but 3 individual symptoms) significantly correlated with attempted suicide; recklessness (AOR = 1.7), anhedonia (AOR = 1.7), and negative beliefs (AOR = 1.6) were most strongly correlated. Mood/cognitive alterations-a cluster new to the DSM-5-were particularly associated with suicide attempts (AOR = 3.2). Childhood maltreatment was strongly associated with attempted suicide; childhood physical abuse (AOR = 2.9) was the only trauma type significantly correlated with suicide attempts after adjustment for multiple testing. Attempted suicide was significantly correlated with substance-related problems in general (AOR = 2.6) and alcohol specifically (AOR = 2.9).

Conclusions: As predicted, suicide attempts correlated with PTSD symptom severity, childhood maltreatment, and substance-related problems. Our hypothesized correlation between suicide and benzodiazepine prescriptions was in part explained by PTSD symptom severity.

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology
  • Benzodiazepines / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychotropic Drugs / therapeutic use
  • Self Report
  • Severity of Illness Index
  • Sex Factors
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Suicide, Attempted*

Substances

  • Psychotropic Drugs
  • Benzodiazepines