Open Access
Substance use disorder and lifetime suicidal behaviour: a scoping review
(Elsevier, 2024) Leza González, Leire; Haro Escribano, Begoña; López-Goñi, José Javier; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Suicidal behaviours are prevalent in substance use disorder (SUD) patients. These behaviours have a negative impact on the psychopathological profile of these patients. However, few studies have evaluated suicide as a continuum (i.e. starting with ideation, followed by attempts and ending with death) and its evolution during treatment. The aim of this scoping review was to explore what is known about suicidal behaviour in individuals undergoing clinical treatment for SUD. Methods: The PsycINFO, Web of Science (Core Collection and MEDLINE), Scopus, and Cochrane Library databases were searched. After screening the records based on eligibility and exclusion criteria, 30 studies were ultimately selected for inclusion. Results: Most of the studies were conducted in the USA and Europe. Only three studies evaluated suicidal behaviour with a specific instrument. The prevalence of suicidal ideation (SI) in people being treated for SUD ranged from 20 % to 62.2 %, and the prevalence of suicide attempts (SA) ranged from 15.8 % to 52.1 %. Only one study reported death by suicide. Conclusions: Despite the high prevalence of suicidal behaviours and their harmful consequences, the assessment of this phenomenon is scarce and heterogeneous. There is a need to assess suicidal behaviour with standardized criteria in order to develop tailored SUD treatment.
Open Access
Prevalence and differential profiles of people with adverse childhood experiences in treatment for substance use disorder
(Cambridge University Press, 2025-04-07) Leza González, Leire; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Adverse childhood experiences (ACEs) are prevalent in people with substance use disorder (SUD). The aims of this study were to determine the prevalence of ACEs in a specific sample of people with SUD and to analyze the specific characteristics of these patients according to gender. The studied sample consisted of 215 people seeking treatment for SUD in two clinical centers in Spain. Descriptive and comparison analyses were carried out, and a logistic regression analysis was conducted to identify the main variables related to ACEs. The prevalence of at least one ACE was 82.3%. Women reported a higher prevalence of family mental health problems (p = .045; d = 0.14) and sexual abuse (p < .001; d = 0.43) than men. The group with ≥3 ACEs showed a higher severity profile for the addiction severity and psychopathological variables than the groups with 0 ACEs and 1–2 ACEs. Logistic regression showed that problems related to the group with ≥3 ACEs in the total sample were psychiatric and legal problems and lifetime suicidal ideation (in men, family/social problems and lifetime suicidal ideation; in women, employment/support problems). This study supports the high prevalence of ACEs in people with SUD and the cumulative effect of ACEs. In addition, gender is a relevant factor. The implementation of assessments and treatment for ACEs is necessary in SUD treatment programs.
Open Access
Relationship between family mental health problems and substance use disorders: a gender perspective analysis
(Taylor and Francis Group, 2023) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Leza González, Leire; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Little is known about family mental illness and substance use disorder (SUD). This casecontrol study explored the relationship between family (parents and/or siblings) mental health problems (FMHP) and lifetime substance use disorder (SUD), considering a gender perspective. Methods: A sample of 387 patients (n = 306 men, 79.1%; n = 81 women, 20.9%) was recruited from the Proyecto Hombre Navarra (Spain) addiction treatment program. Patients with (80 men; 24 women) and without (226 men; 57 women) FMHP were compared, taking sex into account. Results: The prevalence of FMHP was 26.9%, without significant differences between men (n = 80; 26.1%) and women (n = 24; 29.6%). Men with FMHP reported higher severity in family/social and psychiatric areas than those without FMHP. Women with FMHP reported a higher severity in the psychiatric area and a higher prevalence of anxiety problems, suicidal attempts, previous psychopharmacological treatments, and physical abuse than women without FMHP. Conclusions: FMHP is highly prevalent in patients with SUD. They are associated with lifetime psychopathological problems, mainly in men. Further specific research is needed to evaluate this issue to develop specific treatments tailored to the needs of patients with FMHP.
Open Access
Suicidal behaviours in people seeking treatment for substance use disorder
(Elsevier, 2025-03-13) Leza González, Leire; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Sánchez Torres, Ana María; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Little is known about the specific characteristics of suicidal behaviour in people receiving treatment for substance use disorder (SUD). The aim of this study was to describe the number and types of suicide attempts and the methods used by 215 patients with SUD, according to sex. A face to face interview (Columbia Scale Severity Rate) was conducted. Lifetime suicidal ideation was reported by 48.8 % (n = 105) of the patients, and lifetime suicide attempts by 28.4 % (n = 61). Forty-five patients reported actual suicide attempts (20.9 %), and overdose was the most common method used (52.5 %; n = 32). Women had more aborted attempts than men did. Most of the participants who attempted suicide made only one attempt (n = 34; 55.7 %). The projection of these figures is alarming. These results justify the need to integrate suicide prevention interventions into addiction treatment programmes.
Embargo
Experiencias adversas en la infancia y trastornos adictivos en la edad adulta
(2024) Leza González, Leire; Fernández-Montalvo, Javier; López-Goñi, José Javier; Ciencias de la Salud; Osasun Zientziak
En el campo de la investigación científica y en concreto en el ámbito de las adicciones, los factores relacionados con la infancia han ido tomando mayor importancia en los últimos años. La exposición a determinadas experiencias durante los primeros años de vida puede acarrear consecuencias negativas para la salud física y/o mental a corto, medio y largo plazo. Una de las posibles consecuencias es el consumo de sustancias de manera temprana y, por consiguiente, el posterior desarrollo de un trastorno por consumo de sustancias (TCS). Por ello, la presente tesis doctoral tiene como objetivo profundizar en la relación entre haber sufrido determinadas experiencias adversas en los primeros 18 años de vida y el posterior desarrollo de un trastorno adictivo. La tesis está compuesta por seis capítulos. El capítulo I introduce el tema de la tesis mediante una revisión del concepto de Experiencias Adversas en la Infancia (EAI), de sus consecuencias para la salud general, física y mental y, en concreto, de su relación con las adicciones. El capítulo II recoge los objetivos e hipótesis de la tesis. Los siguientes tres capítulos (Capítulos III, IV y V) presentan los tres artículos que componen esta tesis doctoral. Dichos estudios están publicados o siendo revisados por revistas científicas de gran impacto internacional. El primer artículo tiene como objetivo revisar la evidencia existente acerca de la relación entre las EAI y el TCS. En él se ha llevado a cabo una revisión de alcance. El segundo estudio establece la prevalencia de las EAI en una población especifica de TCS. Además, evalúa el perfil diferencial entre tres grupos dependiendo del número de EAI que han experimentado los sujetos que los componen (0 EAI, 1 o 2 EAI y ≥3 EAI). El tercer estudio analiza la presencia, en una muestra específica de personas con TCS, de un tipo de EAI especifico, como es la convivencia durante los primeros 18 años de vida con algún miembro de la familia (padre, madre y/o hermanos) con problemas de salud mental. Asimismo, se ha evaluado la relación entre este tipo de EAI y la presencia y gravedad del TCS teniendo en cuenta la perspectiva de género. Por último, en el capítulo VI se describen las conclusiones generales y se discuten los principales resultados de la tesis doctoral. Además, se presentan las limitaciones y fortalezas de cada uno de los estudios, así como las posibles líneas futuras de investigación derivadas de esta tesis.
Open Access
Lifetime suicidal-related behaviour among patients in treatment for substance use disorder: a cross-sectional study
(Elsevier, 2022) Siria Mendaza, Sandra; Leza González, Leire; López-Goñi, José Javier; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Suicidal-related behaviours are an important concern in individuals who present with substance use disorders (SUDs). The distinction among the specific characteristics of the different patients might help to improve prevention strategies. We describe and compare the sociodemographic characteristics, severity of addiction, and psychopathology of the participants depending on the severity of their lifetime suicidal behaviour. In addition, we examine whether the number of suicide attempts can be estimated based on the variables that differentiate the groups. A sample of 318 men and 86 women who sought treatment for addiction were assessed. The sample was divided into: no ideation or attempts, suicidal ideation, one suicide attempt, and two or more suicide attempts. The group with two or more suicide attempts exhibited a greater severity in the addiction profile. The group with one suicide attempt presented a higher psychopathological symptomatology at the time of the assessment. The severity of the Psychiatric area was related to the group with two or more attempts and to the number of suicide attempts. The presence of any number of attempts is associated with greater severity of addiction. Providing specific intervention strategies for SUD patients depending on their suicidal behaviours is promising for clinical application.
Open Access
Adverse childhood experiences (ACEs) and substance use disorder (SUD): a scoping review
(Elsevier, 2021) Leza González, Leire; Siria Mendaza, Sandra; López-Goñi, José Javier; Fernández-Montalvo, Javier; Ciencias de la Salud; Osasun Zientziak
Background: The long-term negative effects of adverse childhood experiences (ACEs) and their impact on physical and mental health has been widely studied. However, research about the relationship between ACEs and substance use disorder (SUD) diagnosis in adolescence and adulthood is still scarce. Therefore, this scoping review was conducted to collect the existing research findings to explore the relationship between the experience of ACEs and the diagnosis of SUD later in life. Methods: The PsycINFO, Medline, Scopus, Web of Science, and Cochrane Library databases were searched. After identifying the records based on eligibility and exclusion criteria, 12 studies were finally selected for inclusion. Results: Most of the studies were conducted in the USA with adult male and female participants. All studies were cross-sectional in nature and assessed ACEs retrospectively. The main conclusions of the studies were that there is a higher prevalence of ACEs in the population with SUD than in the general population, and a positive association between ACEs and the development and severity of SUD in adolescence and adulthood. Conclusions: It is difficult to make comparisons between studies and to draw solid conclusions because of the lack of standardized criteria for evaluating ACEs and due to the heterogeneity in the substance types examined. More research is needed to fully elucidate the underlying mechanism of the relationship between ACEs and SUD.
Open Access
Differential psychopathological profile of male intimate partner violence perpetrators depending on problematic alcohol use
(Elsevier, 2021) Siria Mendaza, Sandra; Leza González, Leire; Fernández-Montalvo, Javier; Echauri, José Antonio; Azcárate, Juana M.; Ciencias de la Salud; Osasun Zientziak
Objective: This study explored the differential psychopathological profile between male perpetrators of intimate partner violence (IPV) with and without problematic alcohol use (PAU). Method: A sample of 981 men was recruited from a specialized IPV perpetrators treatment programme. All of them were assessed with the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anger Expression Inventory-2 (STAXI-2), and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Comparisons between perpetrators with (n = 125) and without (n = 856) PAU on all the variables studied were carried out. Results: Perpetrators with PAU were less frequently employed and had higher rates of previous psychiatric history and childhood family violence. Moreover, they presented with higher levels of cognitive biases about women and violence. On a psychopathological level, participants with PAU reported significantly higher scores on the SCL90-R, on the STAXI-2, and on almost all the MCMI-III scales than did those without PAU. The multivariate logistic regression analyses showed that the main variables related to PAU were as follows: higher levels of previous psychiatric history, distorted thoughts about women, depression, drug dependence, and various personality disorders (bipolar, dysthymia, antisocial, avoidant, borderline, and schizotypal); and lower scores on internal control, anger reaction, paranoid ideation, and schizoid personality disorders. Discussion: IPV perpetrators with PAU have a more severe psychopathological profile than those without PAU. Additionally, several variables along with PAU may have contributed to the development of IPV. Therefore, tailored interventions should be developed for those perpetrators with PAU.