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Past Childhood Abuse Raises Suicide Risk in Drug Users

Update Date: Jul 18, 2013 05:17 PM EDT

Drug users who suffered childhood abuse are more likely to commit suicide, a new study suggests.

Brown University researchers said that asking patients about a history of childhood abuse could directly help assess their risk of attempting suicide, according to the study published in the American Journal of Public Health.

The latest study involved more than 1,600 drug users in Vancouver, Canada.  Even after accounting for a wide variety of other suicide-related factors, researchers found that "severe-to-extreme" abuse, particularly emotional or sexual, contributed significantly to the risk of future suicide attempts.

The study found that less severe abuse, and physical or emotional neglect no matter the degree, did not contribute significantly to suicide risk.

"This study show that all of forms of childhood abuse, be it emotional, physical, or sexual, are important risk factors for suicide to various degrees," study lead author Brandon Marshall, assistant professor of epidemiology in the Brown University School of Public Health, said in a news release.

"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," he added.

In the study, researchers used the Childhood Trauma Questionnaire (CTQ) that produces a distinct score for each of five trauma categories (sexual, physical, and emotional abuse and physical and emotional neglect) to asses each subject's history of childhood abuse and neglect.

During the study staff including trained nurses followed up with participants every six months. 

Study results revealed 80 participants reported 97 suicide attempts over the study period. Researchers note that this rate of suicide attempts is about five times greater than in the general population.

After accounting for other factors that also predict suicide risk like depression, prior suicidal ideation or homelessness, researchers found that only "severe-to-extreme" abuse resulted in a significantly elevated risk of suicide attempts - 2.9 times for emotional abuse, 2.8 times for sexual and 1.6 for physical - compared to "none-to-minimal" abuse.

"I didn't think there'd be enough power to show these relationships but there was and I think that demonstrates how detrimental childhood trauma can be," Marshall said. "We saw extremely strong associations, which suggest that abuse has lasting mental health impacts well into adulthood."

While the best long-term public health strategy to reduce suicides would be to prevent child abuse in the first place, researchers said that health providers can still help prevent suicide through secondary prevention by identifying victims of such abuse and providing treatment meant to mitigate their elevated suicide risk.

Researchers said the study provides insight into both the resilience of the human spirit and the tragic limits of that resilience.

"There might be a level of resiliency in people who have experienced more minor forms of abuse, but very severe cases were linked with multiple suicide attempts," Marshall said.

"These results will allow us to focus future intervention efforts," he concluded.

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