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Risk factors for unnatural death : Fatal accidental intoxication, undetermined intent and suicide: Register follow-up in a criminal justice population with substance use problems

OLSSON, MARTIN LU ; Brådvik, Louise LU ; Öjehagen, Agneta LU and Håkansson, Anders C LU (2016) In Drug and Alcohol Dependence 162. p.81-176
Abstract

BACKGROUND: Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively.

METHODS: A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested... (More)

BACKGROUND: Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively.

METHODS: A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested in bivariate analysis with the respective cause of death, yielding significant risk factors further analyzed in three Cox regression models.

RESULTS: In Cox regression analyses, death from fatal accidental intoxication was associated with male gender (HR 4.09), use of heroin (HR 2.86), and use of cannabis (HR 1.94), and death from intoxication/injury of undetermined intent was associated with use of heroin (HR 3.48), binge drinking of alcohol (HR 2.46) and previous psychiatric hospitalization (HR 2.41), while negatively associated with depression (HR 0.33). Death from suicide was associated with previous suicide attempts (HR 2.78) and use of sedatives (HR 2.17).

CONCLUSIONS: In this population of criminal justice clients with reported substance use problems, fatal injuries/intoxications with undetermined intent - like fatal accidental intoxications - appear to be associated with substance use variables, and cannot readily be assumed to represent the same background factors as suicide.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Drug and Alcohol Dependence
volume
162
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:84962343610
  • wos:000375165000023
ISSN
1879-0046
DOI
10.1016/j.drugalcdep.2016.03.009
language
English
LU publication?
yes
id
ea2b58a2-898a-4fa1-925b-546056329a34
date added to LUP
2016-04-18 12:45:09
date last changed
2017-04-09 04:45:07
@article{ea2b58a2-898a-4fa1-925b-546056329a34,
  abstract     = {<p>BACKGROUND: Risk factors for suicide and fatal accidental intoxication are extensively studied, while risk factors for intoxications/injuries of undetermined intent are less well known. The latter have shown an overlap with suicides, but also with fatal accidental intoxications. The objective was to analyze potential differences and similarities in the patterns of risk factors for accidental intoxications, injuries/intoxications with undetermined intent, and suicides, respectively.</p><p>METHODS: A follow-up register study was conducted, using data from ASI interviews with clients in the criminal justice system in Sweden (n=6744), followed in the National Causes of Death Register. A set of risk factors from the ASI interview were tested in bivariate analysis with the respective cause of death, yielding significant risk factors further analyzed in three Cox regression models.</p><p>RESULTS: In Cox regression analyses, death from fatal accidental intoxication was associated with male gender (HR 4.09), use of heroin (HR 2.86), and use of cannabis (HR 1.94), and death from intoxication/injury of undetermined intent was associated with use of heroin (HR 3.48), binge drinking of alcohol (HR 2.46) and previous psychiatric hospitalization (HR 2.41), while negatively associated with depression (HR 0.33). Death from suicide was associated with previous suicide attempts (HR 2.78) and use of sedatives (HR 2.17).</p><p>CONCLUSIONS: In this population of criminal justice clients with reported substance use problems, fatal injuries/intoxications with undetermined intent - like fatal accidental intoxications - appear to be associated with substance use variables, and cannot readily be assumed to represent the same background factors as suicide.</p>},
  author       = {OLSSON, MARTIN and Brådvik, Louise and Öjehagen, Agneta and Håkansson, Anders C},
  issn         = {1879-0046},
  language     = {eng},
  month        = {05},
  pages        = {81--176},
  publisher    = {Elsevier},
  series       = {Drug and Alcohol Dependence},
  title        = {Risk factors for unnatural death : Fatal accidental intoxication, undetermined intent and suicide: Register follow-up in a criminal justice population with substance use problems},
  url          = {http://dx.doi.org/10.1016/j.drugalcdep.2016.03.009},
  volume       = {162},
  year         = {2016},
}