Abstract：
BACKGROUND: Abuse/dependence and acute use of ethanol and illicit drug are considered risk factors for suicide. The risk is also influenced by demographic conditions and/or psychiatric comorbidity. The aim of the study was to test the association between presence of ethanol, illicit substances and prescribed drugs in suicide decedents and controls.
METHODS: Case-control study of autopsies performed in the Biscay Forensic Pathology Service, Basque Country, Spain from 01/01/2010 to 30/06/2021 in subjects between 15 and 55 years old. Suicide deaths (n=481) with completed autopsy were evaluated. Concurrent natural deaths were chosen as controls (n=330). The risk for suicide according to demographic, toxicological and psychiatric variables was analyzed using logistic regression.
RESULTS: Ethanol was present in 21% and illicit drugs, mainly cannabis, cocaine and amphetamine, in 27% of suicide deaths. Illicit drugs were more frequent among males. In 63% of suicide cases, prescribed psychotropic drugs were detected. In a multivariate analysis, the main risk factors for suicide were psychiatric diagnosis of illicit drug abuse/dependence (OR=5.56, 95% CI 2.74-11.30) or another mental disease as mood or psychotic disorders (OR=13.05, 95% CI 8.79-19.37). Acute presence of ethanol (OR=4.22, 95% CI 2.52-7.08), recent use of cocaine (OR=2.52, 95% CI 1.05-6.07) and age <35 years (OR=2.50, 95% CI 1.62-3.87) were also associated with suicide deaths.
CONCLUSIONS: The presence of drugs of abuse in suicide deaths of people ≤55 years old is high. Recent use of ethanol and cocaine is significantly associated with an increased suicide risk. Specific prevention strategies against exposition to substances of abuse should be promoted, especially in psychiatric patients.
METHODS: Case-control study of autopsies performed in the Biscay Forensic Pathology Service, Basque Country, Spain from 01/01/2010 to 30/06/2021 in subjects between 15 and 55 years old. Suicide deaths (n=481) with completed autopsy were evaluated. Concurrent natural deaths were chosen as controls (n=330). The risk for suicide according to demographic, toxicological and psychiatric variables was analyzed using logistic regression.
RESULTS: Ethanol was present in 21% and illicit drugs, mainly cannabis, cocaine and amphetamine, in 27% of suicide deaths. Illicit drugs were more frequent among males. In 63% of suicide cases, prescribed psychotropic drugs were detected. In a multivariate analysis, the main risk factors for suicide were psychiatric diagnosis of illicit drug abuse/dependence (OR=5.56, 95% CI 2.74-11.30) or another mental disease as mood or psychotic disorders (OR=13.05, 95% CI 8.79-19.37). Acute presence of ethanol (OR=4.22, 95% CI 2.52-7.08), recent use of cocaine (OR=2.52, 95% CI 1.05-6.07) and age <35 years (OR=2.50, 95% CI 1.62-3.87) were also associated with suicide deaths.
CONCLUSIONS: The presence of drugs of abuse in suicide deaths of people ≤55 years old is high. Recent use of ethanol and cocaine is significantly associated with an increased suicide risk. Specific prevention strategies against exposition to substances of abuse should be promoted, especially in psychiatric patients.
摘要：
背景：滥用/依赖和急性使用乙醇和非法药物被认为是自杀的危险因素。风险还受到人口状况和/或精神病合并症的影响。这项研究的目的是测试乙醇的存在之间的关联，自杀死者和控制中的非法物质和处方药。
方法：在比斯开法医病理服务处进行尸检的病例对照研究，巴斯克地区,西班牙从2010年1月1日至2021年6月30日在15至55岁之间的受试者中。评估了完成尸检的自杀死亡（n=481）。选择同期自然死亡作为对照(n=330)。根据人口统计，自杀的风险，使用逻辑回归分析毒理学和精神病学变量。
结果：乙醇占21%，非法药物，主要是大麻,可卡因和安非他明,在27％的自杀死亡中。非法药物在男性中更为常见。在63%的自杀案例中,发现处方精神药物。在多变量分析中，自杀的主要危险因素是精神病诊断为非法药物滥用/依赖（OR=5.56，95％CI2.74-11.30）或其他精神疾病为情绪或精神障碍（OR=13.05，95％CI8.79-19.37）。急性存在乙醇（OR=4.22，95%CI2.52-7.08），最近使用可卡因(OR=2.52,95%CI1.05-6.07)和年龄<35岁(OR=2.50,95%CI1.62-3.87)也与自杀死亡相关.
结论：55岁以下人群的自杀死亡中滥用药物的发生率很高。最近使用乙醇和可卡因与自杀风险增加显著相关。应促进防止滥用药物的具体预防战略，尤其是精神病患者。
方法：在比斯开法医病理服务处进行尸检的病例对照研究，巴斯克地区,西班牙从2010年1月1日至2021年6月30日在15至55岁之间的受试者中。评估了完成尸检的自杀死亡（n=481）。选择同期自然死亡作为对照(n=330)。根据人口统计，自杀的风险，使用逻辑回归分析毒理学和精神病学变量。
结果：乙醇占21%，非法药物，主要是大麻,可卡因和安非他明,在27％的自杀死亡中。非法药物在男性中更为常见。在63%的自杀案例中,发现处方精神药物。在多变量分析中，自杀的主要危险因素是精神病诊断为非法药物滥用/依赖（OR=5.56，95％CI2.74-11.30）或其他精神疾病为情绪或精神障碍（OR=13.05，95％CI8.79-19.37）。急性存在乙醇（OR=4.22，95%CI2.52-7.08），最近使用可卡因(OR=2.52,95%CI1.05-6.07)和年龄<35岁(OR=2.50,95%CI1.62-3.87)也与自杀死亡相关.
结论：55岁以下人群的自杀死亡中滥用药物的发生率很高。最近使用乙醇和可卡因与自杀风险增加显著相关。应促进防止滥用药物的具体预防战略，尤其是精神病患者。
