Drug Users Abused As Children Are At Higher Risk for Suicide Attempts

A five-year longitudinal study that tracked more than 1,600 drug users in Vancouver, Canada found that severe abuse in their childhood – emotional, sexual and to a lesser extent physical – significantly elevated their risk of attempting suicide. The research, led by Brandon Marshall, PhD, and conducted while a postdoctoral fellow at the Mailman School of Public Health, shows that childhood abuse can have life-and-death consequences for the rest of a person’s life.

Study findings are online in the American Journal of Public Health.

The authors found that “severe-to-extreme” abuse – particularly emotional or sexual – contributed significantly to the risk of future suicide attempts, even after accounting for a wide variety of other suicide-related factors. Less severe abuse, and physical or emotional neglect no matter the degree, did not contribute significantly to suicide risk.

Among the 1,634 participants, 23 percent reported suffering “severe-to-extreme” sexual abuse, 25 percent suffered that degree of physical abuse, and 32 percent endured that degree of emotional abuse.
Over the course of the study 80 participants reported 97 suicide attempts. This is a rate of suicide attempts about five times greater than in the general population.

“Our study shows that all of forms of childhood abuse, be it emotional, physical, or sexual are important risk factors for suicide to various degrees,” said Dr. Marshall, now an assistant professor of Epidemiology in the Brown University School of Public Health. “Care providers and health professionals should screen for these types of abuse and intervene whenever they see a situation of severe abuse, regardless of what type it was.”

“This study is a good illustration of the influence of lifecourse exposures on adult health behaviors” notes Dr. Sandro Galea, Gelman professor and chair of the Department of Epidemiology at the Mailman School and study co-author. “Our experiences throughout life work together cumulatively to shape later health.”
 
Co- authors on the paper with Drs. Marshall and Galea are and Drs. Evan Wood and Thomas Kerr of the Urban Health Research Initiative at the British Columbia Centre for Excellence in HIV/AIDS and the University of British Columbia, Vancouver.

The study was part of two larger UBC public health projects, the Vancouver Injection Drug Users Study and the AIDS Care Cohort to Evaluate Exposure to Survival Service. Support for the study came from the National Institutes of Health, the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research.