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Study Suggests Prior Violence Is Associated with Greater Risk of Suicidal Thoughts and Attempts in Patients Seeking SUD Treatment


  • Suicidal thoughts and attempts are common in those with substance use disorders (SUD): more than 43% of the participants in this study reported either prior suicide attempts or suicidal ideation at some point in their lives.
  • Even after accounting for other known risk factors, such as symptoms of depression or childhood victimization, a history of violent behavior was consistently associated with a higher likelihood of lifetime suicidal thoughts and behaviors.
  • A history of either suicidal ideation or suicide attempt(s) was more common among substance users who were female and those with a history of depression or childhood abuse.
  • The authors advise that treatment providers be aware that patients with some of the greatest violence in their past are also those at elevated risk for harm to themselves.

Rates of lifetime suicide attempts among patients with a substance use disorder (SUD) are as high as 45%. Several factors associated with a suicide attempt prior to SUD treatment have been identified, including previous suicide attempts, suicidal ideation, depression, psychotic symptoms, and past physical and/or sexual abuse. Research also suggests that prior aggression and/or violence may be an important risk factor; however, the link between violence and suicidal behaviors is still preliminary. This study examined the association between lifetime violent behavior and suicidal thoughts and attempts in a national sample of patients (n=6,233) seeking SUD treatment. Investigators used data from the National Treatment Improvement Evaluation Study - a multi-site study of publicly-funded SUD treatment programs. The present study focused on participants' baseline assessment and included questions about suicidal ideation and prior attempts, prior acts of violence towards others, childhood physical and/or sexual abuse, and previous symptoms of depression. The majority of participants were male (72%), the average age was 32, and 55% were African American.


  • The measures of suicidal thoughts and attempts were based on single items with unknown reliability and validity.
  • No data were available on the level of suicidal intent for prior attempts.

AUTHOR/FUNDING INFORMATION: This study was funded by HSR&D (MRP 05-137). Dr. Ilgen is part of HSR&D's Center for Clinical Management Research in Ann Arbor, MI.

PubMed Logo Ilgen M, Burnette M, Conner K, et al. The Association between Violence and Lifetime Suicidal Thoughts and Behaviors in Individuals Treated for Substance Use Disorders. Addictive Behaviors February 2010;35(2):111-115.

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