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Nicotine use in suicides: a case–control study

Published online by Cambridge University Press:  16 April 2020

Barbara Schneider ,
Axel Schnabel ,
Bernhard Weber ,
Lutz Frölich ,
Konrad Maurer  and
Tilman Wetterling
Axel Schnabel
Affiliation:
Centre of Forensic Medicine, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
Bernhard Weber
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Lutz Frölich
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Konrad Maurer
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Tilman Wetterling
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
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Abstract

Purpose

Despite of higher rates of substance-related disorders in psychiatric patients and suicides than in the general population, there is no clear specificity to the relationship between nicotine use and other psychiatric disorders for suicide risk.

Methods

One hundred and sixty-three suicides (mean age 49.8 ± 19.3 years; 64.4% males; using psychological autopsy method) and 396 control persons (mean age 51.6 ± 17.0 years; 55.8% males) were assessed with a standardised semi-structured interview including SCID-I and SCID-II (for DSM-IV). Suicides and controls were compared in terms of nicotine consumption and psychiatric disorders. Logistic regression was used to evaluate the interactions of tobacco consumption with psychiatric disorders.

Results

Suicides were significantly more often current smokers and heavy users of cigarettes (>20 cigarettes per day; P < 0.001, each). Alcohol dependence, other axis I disorders than substance-related disorders, and cluster B personality disorder(s) remained independent predictors for suicide in both genders, current nicotine consumption only in men (OR = 2.6, 95% CI 1.3–5.2).

Conclusions

In males, but not in females, nicotine consumption contributed to risk of completed suicide after control for psychiatric disorders and has to be considered as independent risk factor for suicide.

Keywords

Nicotine consumptionSuicideRisk factorsPsychiatric disordersPsychological autopsy
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 2 , March 2005 , pp. 129 - 136

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References

Ackermann, HBIAS. Hochheim-Darmstadt: Epsilon-Verlag; 2003Google Scholar
Amering, M, Bankier, B, Berger, P, Griengl, H, Windhaber, J, Katschnig, HPanic disorder and cigarette smoking behavior. Compr Psychiatry 1999;40:35–38.CrossRefGoogle ScholarPubMed
Angst, J, Clayton, PJPersonality, smoking and suicide: a prospective study. J Affect Disord 1998; 51: 55–62.CrossRefGoogle ScholarPubMed
Angst, F, Stassen, HH, Clayton, PJ, Angst, JMortality of patients with mood disorders: follow-up over 34–38 years. J Affect Disord 2002;68: 167–181.CrossRefGoogle ScholarPubMed
Appleby, L, Cooper, J, Amos, T, Faragher, BPsychological autopsy of suicides by people under 35. Br J Psychiatry 1999;175: 168–174.CrossRefGoogle ScholarPubMed
Baxter, D, Appleby, LCase register study of suicide risk in mental disorders. Br J Psychiatry 1999;175: 322–326.CrossRefGoogle ScholarPubMed
Berlin, I, Said, S, Spreux-Varoquaux, O, Olivares, R, Launay, JM, Puech, AJMonoamine oxidase A and B activities in heavy smokers. Biol Psychiatry 1995; 38: 756–761.CrossRefGoogle Scholar
Beskow, J, Runeson, B, Asgard, UPsychological autopsies: methods and ethics. Suicide Life Threat Behav 1990;20: 307–323.Google Scholar
Black, DW, Zimmerman, M, Coryell, WHCigarette smoking and psychiatric disorder in a community sample. Ann Clin Psychiatry 1999;11: 129–136.CrossRefGoogle Scholar
Brent, DA, Baugher, M, Bridge, J, Chen, T, Chiappetta, LAge- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatry 1999;38: 1497–1505.CrossRefGoogle ScholarPubMed
Brent, DA, Bridge, J, Johnson, BA, Connolly, JSuicidal behaviour runs in families. A controlled family study of adolescent suicide victims. Arch Gen Psychiatry 1996;53: 1145–1152.CrossRefGoogle ScholarPubMed
Brent, DA, Johnson, B, Bartle, S, Bridge, J, Rather, C, Matta, Jet al.Personality disorder, tendency to impulsive violence and suicidal behaviour in adolescents. J Am Acad Child Adolesc Psychiatry 1993;32: 69–75.CrossRefGoogle Scholar
Brent, DA, Perper, JA, Kolko, DJ, Zelenak, JPThe psychological autopsy: methodological considerations for the study of adolescent suicide. J Am Acad Child Adolesc Psychiatry 1988;27: 362–366.CrossRefGoogle Scholar
Breslau, N, Kilbey, M, Andreski, PNicotine dependence, major depression, and anxiety in young adults. Arch Gen Psychiatry 1991;48: 1069–1074.CrossRefGoogle ScholarPubMed
Breslau, N, Kilbey, MM, Andreski, PNicotine dependence and major depression. New evidence from a prospective investigation. Arch Gen Psychiatry 1993;50: 31–35.CrossRefGoogle ScholarPubMed
Breslau, N, Kilbey, MM, Andreski, PDSM-III-R nicotine dependence in young adults: prevalence, correlates and associated psychiatric disorders. Addiction 1994;89: 743–754.CrossRefGoogle ScholarPubMed
Breslau, N, Klein, DFSmoking and panic attacks: an epidemiologic investigation. Arch Gen Psychiatry 1999;56: 1141–1147.CrossRefGoogle ScholarPubMed
Breslau, NPsychiatric comorbidity of smoking and nicotine dependence. Behav Genet 1995;25: 95–101.CrossRefGoogle ScholarPubMed
Brook, DW, Brook, JS, Zhang, C, Cohen, P, Whiteman, MDrug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders. Arch Gen Psychiatry 2002;59: 1039–1044.CrossRefGoogle ScholarPubMed
Burling, TA, Ziff, DCTobacco smoking: a comparison between alcohol and drug abuse inpatients. Addict Behav 1988;13: 185–190.CrossRefGoogle ScholarPubMed
Cavanagh, JTO, Carson, AJ, Sharpe, M, Lawrie, SMPsychologcial autopsy studies of suicide: a systematic review. Psychol Med 2003;33:395–405.CrossRefGoogle Scholar
Cavanagh, JTO, Owens, DGC, Johnstone, ECLife events in suicide and undetermined death in south-east Scotland: a case–control study using the method of psychological autopsy. Soc Psychiatry Psychiatr Epidemiol 1999;34: 645–650.CrossRefGoogle ScholarPubMed
Cheng, ATAMental illness and suicide. A case–control study in East Taiwan. Arch Gen Psychiatry 1995;52: 594–603.CrossRefGoogle ScholarPubMed
Cheng, ATA, Mann, AH, Chan, KAPersonality disorder and suicide. A case–control study. Br J Psychiatry 1997;170: 441–446.CrossRefGoogle ScholarPubMed
Conner, KR, Duberstein, PR, Conwell, YThe validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. I. Psychiatric diagnoses. Acta Psychiatr Scand 2001;104: 204–209.CrossRefGoogle ScholarPubMed
De Hert, M, McKenzie, K, Peuskens, JRisk factors for suicide in young patients suffering from schizophrenia. Schizophr Res 2001;47: 127–134.CrossRefGoogle ScholarPubMed
De Hert, M, Peuskens, JFirst-episode schizophrenia, a naturalistic 10 year follow-up study. Schizophr Res 1998;29: 7–8.CrossRefGoogle Scholar
Di Franza, JR, Guerrera, MPAlcoholism and smoking. J Stud Alcohol 1990;51: 130–135.CrossRefGoogle Scholar
Diwan, A, Castine, M, Pomerleau, CS, Meador-Woodruff, JH, Dalack, GWDifferential prevalence of cigarette smoking in patients with schizophrenic vs. mood disorders. Schizophr Res 1998;33: 113–118.CrossRefGoogle ScholarPubMed
Doll, R, Peto, RMortality in relation to smoking: 20 years’ observations on male British doctors. Br Med J 1976;2: 1525–1536.CrossRefGoogle ScholarPubMed
Dorpat, TL, Ripley, HSA study of suicide in the Seattle area. Compr Psychiatry 1960;1: 349–359.CrossRefGoogle ScholarPubMed
Fergusson, DM, Lynskey, MT, Horwood, LJComorbidity between depressive disorders and nicotine dependence in a cohort of 16-year-olds. Arch Gen Psychiatry 1996;53: 1043–1047.CrossRefGoogle Scholar
Fleiss, JLThe measurement of interrater agreement. Statistical methods for rates and proportions. New York: Wiley; 1981.212–236.Google Scholar
Foster, T, Gillespie, K, McClelland, R, Patterson, CRisk factors for suicide independent of DSM-III-R Axis I disorder. Case–control psychological autopsy study in Northern Ireland. Br J Psychiatry 1999; 175: 175–179.CrossRefGoogle ScholarPubMed
Fydrich, T, Renneberg, B, Schmitz, B, Wittchen, HUStrukturiertes Klinisches Interview für DSM-IV, Achse II: Persönlichkeitsstörungen. Eine deutschsprachige erweiterte Bearbeitung der amerikanischen Originalversion des SCID-II. Göttingen: Hogrefe; 1997.Google Scholar
Galanti, LM, Manigart, P, Dubois, PTobacco smoking and alcohol and drug consumption in a large, young healthy population. Arch Environ Health 1998;53: 156–160.CrossRefGoogle Scholar
Hamera, E, Kraenzle-Schneider, J, Deviney, SAlcohol, cannabis, nicotine, and caffeine use and symptom distress in schizophrenia. J Nerv Ment Dis 1995;183: 559–565.CrossRefGoogle Scholar
Harris, EC, Barraclough, BSuicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry 1997 ;170:205–228.CrossRefGoogle ScholarPubMed
Harris, EC, Barraclough, BExcess mortality of mental disorder. Br J Psychiatry 1998;173: 11–53.CrossRefGoogle ScholarPubMed
Haustein, KO, Haffner, S, Woodcock, BGA review of the pharmacological and psychopharmacological aspects of smoking and smoking cessation in psychiatric patients. Int J Clin Pharmacol Ther 2002;40: 404–418.CrossRefGoogle ScholarPubMed
Hawton, K, Simkin, S, Rue, J, Haw, C, Barbour, F, Clements, Aet al.Suicide in female nurses in England and Wales. Psychol Med 2002 ;32:239–250.CrossRefGoogle ScholarPubMed
Hemenway, D, Solnick, SJ, Colditz, GASmoking and suicide among nurses. Am J Public Health 1993;83: 249–251.CrossRefGoogle ScholarPubMed
Henriksson, MM, Aro, HM, Marttunen, MJ, Heikkinen, ME, Isometsä, ET, Kuoppasalmi, KIet al.Mental disorders and comorbidity in suicide. Am J Psychiatry 1993;150: 935–940.Google ScholarPubMed
Hiroeh, U, Appleby, L, Mortensen, PB, Dunn, GDeath by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study. Lancet 2001;358: (9299): 2110–2112.CrossRefGoogle ScholarPubMed
Houston, K, Hawton, K, Sheppard, RSuicide in young people aged 15–24: a psychological autopsy study. J Affect Disord 2001;63: 159–170.CrossRefGoogle ScholarPubMed
Isometsä, ETPsychological autopsy studies—a review. Eur Psychiatry. 16:2001 379–385.CrossRefGoogle ScholarPubMed
John, U, Meyer, C, Rumpf, HJ, Hapke, UProbabilities of alcohol high risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence. Addiction 2003;98: 805–814.CrossRefGoogle ScholarPubMed
Johnson, JG, Cohen, P, Pine, DS, Klein, DF, Kasen, S, Brook, JSAssociation between cigarette smoking and anxiety disorders during adolescence and early adulthood. J Am Med Assoc.2000;284: 2348–2351.CrossRefGoogle ScholarPubMed
Junge, B, Nagel, MDas Rauchverhalten in Deutschland. Gesundheitswesen 1999;61: 121–125.Google Scholar
Kandel, D, Chen, K, Warner, LA, Kessler, RC, Grant, BPrevalence and demographic correlates of symptoms of last year dependence on alcohol, nicotine, marijuana and cocaine in the US population. Drug Alcohol Depend 1997;44: 11–29.CrossRefGoogle Scholar
Kraus, L, Augustin, RRepräsentativerhebung zum Konsum psychotroper Substanzen bei Erwachsenen in Deutschland 2000. Sucht 2001;47: Sonderheft 1CrossRefGoogle Scholar
Kelly, TM, Mann, JJValidity of DSM-III-R diagnosis by psychological autopsy: a comparison with clinician ante-mortem diagnosis. Acta Psychiatr Scand 1996;94: 337–343.CrossRefGoogle ScholarPubMed
Kendler, KS, Neale, MC, McLean, CJ, Heath, AC, Eaves, LJ, Kessler, RCSmoking and major depression: a causal analysis. Arch Gen Psychiatry 1993;50: 36–43.CrossRefGoogle ScholarPubMed
Leistikow, BN, Martin, DC, Samuels, SJInjury death excesses in smokers: a 1990–95 United States national cohort study. Inj Prev 2000;6: 277–280.CrossRefGoogle ScholarPubMed
Lesage, AD, Boyer, R, Grunberg, F, Vanier, C, Morissette, R, Menard-Buteau, Cet al.Suicide and mental disorders: a case–control study of young men. Am J Psychiatry 1994;151: 1063–1068.Google ScholarPubMed
Malone, KM, Waternaux, C, Haas, GL, Cooper, TB, Li, S, Mann, JJCigarette smoking, suicidal behaviour, and serotonin function in major psychiatric disorders. Am J Psychiatry 2003;160: 773–779.CrossRefGoogle ScholarPubMed
Meyer, C, Rumpf, HJ, Schumann, A, Hapke, U, John, UIntentionally reduced smoking among untreated general population smokers: prevalence, stability, prediction of smoking behaviour change and differences between subjects choosing either reduction or abstinence. Addiction 2003;98: 1101–1110.CrossRefGoogle ScholarPubMed
Miller, M, Hemenway, D, Bell, NS, Yore, MM, Amoroso, PJCigarette smoking and suicide: a prospective study of 300 000 male active-duty army soldiers. Am J Epidemiol 2000;151: 1060–1063.CrossRefGoogle ScholarPubMed
Miller, M, Hemenway, D, Rimm, ECigarettes and suicide: a prospective study of 50 000 men. Am J Public Health 2000;90: 768–773.Google ScholarPubMed
Patten, CA, Gillin, C, Golshan, S, Wolter, TD, Rapaport, M, Kelsoe, JRelationship of mood disturbance to cigarette smoking status among 252 patients with current mood disorder. J Clin Psychiatry 2001;62: 319–324.CrossRefGoogle ScholarPubMed
Pohl, R, Yeragani, VK, Balon, R, Lycaki, H, McBride, RSmoking in patients with panic disorder. Psychiatry Res 1992;43: 253–262.CrossRefGoogle ScholarPubMed
Schneider, BPsychische Erkrankungen—Achse I-Störungen. Risikofaktoren für Suizid. Regensburg: Roderer Verlag; 2003 29–67.Google Scholar
Shaffer, D, Gould, MS, Fisher, P, Traufman, P, Moreau, D, Kleinman, Met al.Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry.1996; 53: 339–348.CrossRefGoogle ScholarPubMed
Shafii, M, Steltz-Lenarsky, J, Derrick, AM, Beckner, C, Whittinghill, JRComorbidity of mental disorders in the post-mortem diagnosis of completed suicide in children and adolescents. J Affect Disord 1988;15: 227–233.CrossRefGoogle ScholarPubMed
Smith, GD, Phillips, AN, Neaton, JDSmoking as independent risk factor for suicide: illustration of an artifact from observational epidemiology?. Lancet 1992;340: 709–712.CrossRefGoogle ScholarPubMed
Statistisches Bundesamt Fachserie 12: Gesundheitswesen, Reihe S. 3. Fragen zur Gesundheit 1999. Stuttgart: Metzler-Poeschel; 2000Google Scholar
Tanskanen, A, Tuomilehto, J, Viinamaki, H, Vartiainen, E, Lehtonen, J, Puska, PSmoking and the risk of suicide. Acta Psychiatr Scand 2000;101: 243–245.CrossRefGoogle ScholarPubMed
Tyndale, RFGenetics of alcohol and tobacco use in humans. Ann Med 2003;35: 94–121.CrossRefGoogle ScholarPubMed
Vijayakumar, L, Rajkumar, SAre risk factors for suicide universal? A case–control study in India. Acta Psychiatr Scand 1999;99: 407–411.CrossRefGoogle Scholar
Waern, M, Runeson, BS, Allebeck, P, Beskow, J, Rubenowitz, E, Skoog, Iet al.Mental disorder in elderly suicides: a case–control study. Am J Psychiatry 2002;159: 450–455.CrossRefGoogle ScholarPubMed
Waern, MAlcohol dependence and misuse in elderly suicides. Alcohol Alcohol 2003;38: 249–254.CrossRefGoogle ScholarPubMed
Wittchen, HU, Wunderlich, U, Gruschwitz, S, Zaudig, MStrukturiertes Klinisches Interview für DSM-IV, Achse I. Eine deutschsprachige erweiterte Bearbeitung der amerikanischen Originalversion des SCID-I. Göttingen: Hogrefe; 1997Google Scholar
World Health Organization WHO European country profiles on tobacco control. Copenhagen: WHO Regional Office for Europe; 2003Google Scholar
Yoshimasu, K, Kiyohara, CGenetic influence on smoking behaviour and nicotine dependence: a review. J Epidemiol 2003; 13:183–192.CrossRefGoogle Scholar
Ziedonis, DM, Kosten, TR, Glazer, WM, Frances, RJNicotine dependence and schizophrenia. Hosp Community Psychiatry 1994; 45:204–206.Google Scholar
Zuckerman, M, Kuhlman, DMPersonality and risk-taking: common biosocial factors. J Pers 2000; 68:999–1029.CrossRefGoogle ScholarPubMed
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