Prediction of suicide ideation and attempt among substance-using patients in primary care

Background: suicide is a major public health concern,particularly among people who use illicit substances and/or non-prescribed medications. methods: the present study prospectively assessed the incidence and predictors of suicidal ideation (si) and suicide attempt (sa) among 868 substance-using patients over 12 months after receiving primary care within seven public primary care clinics. results: participants reported a high incidence of si (25.9%) and sa (7.1%) over the year following primary care visits. suicidality was elevated in patients who were female; lacked a high school diploma; were unemployed; reported depression,anxiety,hallucinations,concentration difficulty,or violent behavior; used nicotine or stimulants; used the emergency department or mental health services in the past 90 days; reported current quality-of-life impairment in mobility or usual activities; or reported recent si or lifetime sa at baseline. in multiple regression analyses,only past 30-day si,any lifetime sa,past 90-day violent behavior,and current impairment due to anxiety or depression at baseline uniquely predicted si or sa beyond other variables. conclusions: results support the need for screening for suicidality among primary care patients who use illicit substances and identify key of these patients who are at particularly elevated risk for suicidality.