Özcan UZUN, Cemil ÇELİK, Abdullah BOLU, Taner ÖZNUR, Kamil Nahit OZMENLER, Şahin KAYMAK, Havva ÖZNUR, Serdar ATİK, Abdullah AKGÜN

Uyum bozukluğunda intihar girişimi ile sentetik kanabinoid kullanımı arasındaki ilişki

Amaç: Uyum bozukluğu tanısı olan erişkin hastaların, adolesanlara benzer şekilde intihar davranışında bulunmadıkları bilinmesine rağmen, bunun özel gruplardaki geçerliliği bilinmemektedir. Bu çalışma, askerlik hizmetini yapmakta olan ve intihar girişimi ile sonuçlanan uyum bozukluğu tanısı olan genç erkek bireylerdeki intiharla ilişkili prevalansı ve risk faktörlerini saptamak için tasarlanmıştır. Yöntem: Uyum bozukluğu tanısı alan 202 genç erkeğin 125’i (%61.9) uyum sorunları ile, 77’si (%38.1) intihar girişimi ile başvurdu. Her iki grup demografik özellikler, madde kötüye kullanımı, psikiyatrik hastalıklar, intihar girişimleri, ailede intihar öyküsü, kendine zarar verme girişimleri, fiziksel ve cinsel travma öyküleri açısından karşılaştırıldı. Bulgular: İntihar girişiminde bulunan hastaların %83.1’ i (n=64) ateşli silahlar, asma, atlama, kesici aletler ve yanma dahil olmak üzere başarısız olma ihtimali düşük olan yöntemleri seçmişlerdi. İntihar girişiminde bulunan grup ile intihar girişiminde bulunmayan grup kıyaslandığında, sentetik kanabinoid kullanımı ve kendine zarar verme girişimleri açısından istatistiksel olarak anlamlı farklılıklar bulundu. Ayrıca, sentetik kanabinoidlerin kullanımı geçmişteki intihar girişimleri ile de ilişkilendirildi. Ancak, çalışmanın sonuçlarını uyum bozukluğu olan tüm hastalara genellemek zor görünüyor. Sonuç: Bu bulgular, uyum bozukluğu belirtileri gösteren genç erkeklerde, intihar davranışını öngörmede yol gösterici olabilir.

Relationship Between Suicide Attempts and Synthetic Cannabinoids in Adjustment Disorder

Objective: Although it has been known that adult patients with an adjustment disorder diagnosis donot have suicidal behavior similar to adolescents, the validity of this assertion in particular groups isunknown. This study was designed to determine the prevalence and risk factors associated withsuicide in patients with adjustment disorder that resulted in suicide among young men performingcompulsory military service.Method: Of 202 young men with a diagnosis of adjustment disorder, 125 (61.9%) were admitted withadjustment problems and 77 (38.1%) with suicide attempt. Demographic characteristics, substanceabuse, psychiatric disorders, suicide attempts, family history of suicide, self-mutilation, and physicaland sexual trauma histories of both groups were compared.Results: Of the patients who attempted suicide, 83.1% (n=64) selected methods unlikely to failincluding firearms, hanging, jumping, cutting tools, and burning. Significant differences were foundbetween the two groups (those who attempted suicide versus those who did not) in terms of SC useand self mutilation history. In addition, the use of synthetic cannabinoids was associated with pastsuicide attempts. But, it is difficult to generalize the results of the study to all patients with adjustmentdisorder.Conclusion: These findings may help to predict suicidal behavior in young men showing symptoms ofadjustment disorder.

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Hawton K, van Heeringen K. Suicide. Lancet 2009; 373:1372- 1381. [CrossRef]
Phillips MR. Rethinking the role of mental illness in suicide. Am J Psychiatry 2010; 167:731-733. [CrossRef]
Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry 1997; 170:205-228. [CrossRef]
Hoertel N, Franco S, Wall MM, Oquendo MA, Kerridge BT, Limosin F, Blanco C. Mental disorders and risk of suicide attempt: a national prospective study. Mol Psychiatry 2015; 20:718-726. [CrossRef]
Randall JR, Walld R, Finlayson G, Sareen J, Martens PJ, Bolton JM. Acute risk of suicide and suicide attempts associated with recent diagnosis of mental disorders: a population-based, propensity score– matched analysis. Can J Psychiatry 2014; 59:531-538. [CrossRef]
Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. Eleventh ed., Philadelphia: Wolters Kluwer, 2014.
Oznur T. Clinical and differential diagnosis of adjustment disorder. Turkiye Klinikleri Journal of Psychiatry Special Topics 2015; 8:53-60. (Turkish)
Shakeri J, Farnia V, Abdoli N, Akrami MR, Arman F, Shakeri H. The risk of repetition of attempted suicide among Iranian women with psychiatric disorders as quantified by the suicide behaviors questionnaire. Oman Med J 2015; 30:173-180. [CrossRef]
Manoranjitham SD, Rajkumar AP, Thangadurai P, Prasad J, Jayakaran R, Jacob KS. Risk factors for suicide in rural south India. Br J Psychiatry 2010; 196:26-30. [CrossRef]
Windfuhr K, Kapur N. Suicide and mental illness: a clinical review of 15 years findings from the UK National Confidential Inquiry into Suicide. Br Med Bull 2011; 100:101-121. [CrossRef]
Pelkonen M, Marttunen M, Henriksson M, Lonnqvist J. Suicidality in adjustment disorder – clinical characteristics of adolescent outpatients. Eur Child Adolesc Psychiatry 2005; 14:174-180. [CrossRef]
Pelkonen M, Marttunen M, Henriksson M, Lonnqvist J. Adolescent adjustment disorder: precipitant stressors and distress symptoms of 89 outpatients. Eur Psychiatry 2007; 22:288-295. [CrossRef]
Casey P, Jabbar F, O’Leary E, Doherty AM. Suicidal behaviours in adjustment disorder and depressive episode. J Affect Disord 2015; 174:441-446. [CrossRef]
Pumariega AJ, Burakgazi H, Unlu A, Prajapati P, Dalkilic A. Substance abuse: risk factors for Turkish youth. Bulletin of Clinical Psychopharmacology 2014; 24:5-14. [CrossRef]
Borges G, Bagge CL, Orozco R. A literature review and meta- analyses of cannabis use and suicidality. J Affect Disord 2016; 195:63-74. [CrossRef]
Gorun G, Dermengiu D, Curca GC, Hostiuc S, Ioan B, Luta V. Toxicological drivers issues in “legal highs” use. Romanian Journal of Legal Medicine 2010; 18:271-278. [CrossRef]
Thomas S, Bliss S, Malik M. Suicidal ideation and self-harm following K2 use. J Okla State Med Assoc 2012; 105:430-433.
Kamijo Y, Takai M, Fujita Y, Hirose Y, Iwasaki Y, Ishihara S, Yokoyama T, Yagi K, Sakamoto T. A multicenter retrospective survey of poisoning after consumption of products containing synthetic chemicals in Japan. Intern Med 2014; 53:2439-2445. [CrossRef]
Ashton CH, Moore PB. Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatr Scand 2011; 124:250- 261. [CrossRef]
Rech MA, Donahey E, Cappiello Dziedzic JM, Oh L, Greenhalgh E. New drugs of abuse. Pharmacotherapy 2015; 35:189-197. [CrossRef]
Venables NC, Sellbom M, Sourander A, Kendlere KS, Joiner TE, Drislanea LE, Sillanmäki L, Elonheimo H, Parkkola K, Multimaki P, Patrick CJ. Separate and interactive contributions of weak inhibitory control and threat sensitivity to prediction of suicide risk. Psychiatry Res 2015; 226:461-466. [CrossRef]
Bolu A, Doruk A, Ak M, Ozdemir B, Ozgen F. Suicidal behavior in adjustment disorder patients. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2012; 25:58-62. [CrossRef]
Mergl R, Koburger N, Heinrichs K, Szekely A, Toth MD, Coyne J, Quintao S, Arensman E, Coffey C, Maxwell M, Varnik A, van Audenhove C, McDaid D, Sarchiapone M, Schmidtke A, Genz A, Gusmao R, Hegerl U. What are reasons for the large gender differences in the lethality of suicidal acts? An Epidemiological analysis in four European countries. PloS one 2015; 10:e0129062. [CrossRef]
Bryana CJ, Rudda MD, Wertenbergerd E, Young-McCaughone S, Peterson A. Nonsuicidal self-injury as a prospective predictor of suicide attempts in a clinical sample of military personnel. Compr Psychiatry 2015; 59:1-7. [CrossRef]
Dickstein DP, Puzia ME, Cushman GK, Weissman AB, Wegbreit E, Kim KL, Nock MK, Spirito A. Self-injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self-injury. J Child Psychol Psychiatry 2015; 56:1127- 1136. [CrossRef]
Beghi M, Rosenbaum JF, Cerri C, Cornaggia CM. Risk factors for fatal and nonfatal repetition of suicide attempts: a literature review. Neuropsychiatr Dis Treat 2013; 9:1725-1736.
Boden JM, Fergusson DM, Horwood LJ. Associations between exposure to stressful life events and alcohol use disorder in a longitudinal birth cohort studied to age 30. Drug Alcohol Depend 2014; 142:154-160. [CrossRef]
Carta MG, Balestrieri M, Murru A, Hardoy MC. Adjustment Disorder: epidemiology, diagnosis and treatment. Clin Pract Epidemiol Ment Health 2009; 5:15. [CrossRef]
Yuodelis-Flores C, Ries RK. Addiction and suicide: a review. Am J Addict 2015; 24:98-104. [CrossRef]
Artenie AA, Bruneau J, Roy E, Zang G, Lesperance F, Renaud J, Tremblay J, Jutras-Aswad D. Licit and illicit substance use among people who inject drugs and the association with subsequent suicidal attempt. Addiction 2015; 110:1636-1643. [CrossRef]