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Abstrakt

Nicotine Dependence among Patients Examined in Emergency after a Suicide Attempt

Michel Lejoyeux, Simone Guillermet, Enrique Casalino, Valérie Lequen, Florence Chalvin, Aymeric Petit and Véronique Le Goanvic

Background: To assess the prevalence of nicotine dependence in a population of patients examined following a suicide attempt and to compare suicide attempts with and without nicotine dependence.

Methods: 200 patients were examined in an emergency department after a suicide attempt. They answered the MAST and the Fagerström questionnaire, and the DSM-IV-TR criteria for alcohol and nicotine were checked. We also assessed socio-demographic characteristics, the mode of suicide attempt and level of sensation seeking.

Results: The prevalence of nicotine dependence was 57% among suicide attempters. Suicide attempters with nicotine dependence were more often men (42 vs. 12%, p=0.001), single (67 vs. 32%, p=0.008) and had taken alcohol before suicide. They were often multi-attempters (2.7 vs. 1 suicide attempt in their history) and had been more often hospitalized in psychiatry (1.9 vs. 0.6 hospitalization, p<0.001) than others. They drank more alcohol (3.7 vs. 0.7 drinks/ day, p<0.001), presented more alcohol dependence and abuse (36 vs. 8%, p<0.00001) and had a higher level of sensation seeking. Factors associated to nicotine dependence were male gender, ingestion of alcohol before suicide attempt, number of previous suicide attempts and number of alcohol intoxication per week.

Conclusion: 57% of the patients examined after a suicide attempt present nicotine dependence. Emergency units may provide an opportunity to systematically identify a dependence disorder and to offer appropriate information and treatment.