Risk factors for suicidal behavior in patients hospitalized for adjustment disorders

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Published Jun 28, 2024
https://doi.org/10.62438/tunismed.v102i7.4798
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Vol. 102 No. 7 (2024): Tunis Med jul 2024

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Sabria Khouadja
Psychiatric department of university hospital of Mahdia, Tunisia
Ahmed Mohanned Haddad
University of medicine of Monastir, Tunisia
Samira Younes
Psychiatric department of university hospital of Mahdia, Tunisia
Walid Bouali
Psychiatric department of university hospital of Mahdia, Tunisia
Lazhar Zarrouk
Psychiatric department of university hospital of Mahdia, Tunisia

Abstract

 


Introduction:


Adjustment disorder (AD) is a common psychiatric diagnosis, but it is often considered less severe than other diagnoses. However, it is strongly associated with suicidal behavior.


Aim:


To identify the factors linked to suicidal behavior in patients hospitalized for AD.
Methods:
This is a retrospective, descriptive, and analytical study conducted in the psychiatric department of Mahdia’s hospital over a period of nine years. The study included patients who were hospitalized for the first time due to adjustment disorder, according to DSM-5 diagnostic criteria.
Results:
The study population included 129 patients. AD was prevalent among young (median age 29 years) and female patients (75.2%). Almost half of the cases were single (48.1%) and having a history of suicidal behavior (48.3%). Sixty patients (46.5%) were hospitalized following a suicidal attempt (SA) and drugs were used as a way in half of the cases (50%). Conflicts were the dominant factor precipitating the SA in 88.3% of cases. Factors linked to suicidal behavior in patients with AD were being in an intimate relationship and the presence of family conflicts. Indeed, the risk of suicidal behavior was found to be increased by 3.15 times in patients with AD who experienced family conflicts. Besides, being in an intimate relationship in patients with AD multiplies the risk of suicidal behavior by 5.863.


Conclusions:
Given the high risk of suicide associated with AD, it is essential to have a more in-depth understanding of the suicidal process and AD through new studies.

Keywords:

Psychiatry, Adjustment disorder, Suicide attempt , Tunisia

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References

  1. Maercker A, Lorenz L. Adjustment disorder diagnosis: Improving clinical utility. World J Biol Psychiatry. 2018;19(sup1):S3‑13.
  2. Fegan J, Doherty AM. Adjustment Disorder and Suicidal Behaviours Presenting in the General Medical Setting: A Systematic Review. Int J Environ Res Public Health. 2019 Aug;16(16):2967.
  3. Gradus JL, Qin P, Lincoln AK, Miller M, Lawler E, Lash TL. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide. Clin Epidemiol. 2010 Aug;2:23-8.
  4. Schnyder U, Valach L. Suicide attempters in a psychiatric emergency room population. Gen Hosp Psychiatry. 1997 Mar;19(2):119‑29.
  5. Greenberg WM, Rosenfeld DN, Ortega EA. Adjustment disorder as an admission diagnosis. Am J Psychiatry. 1995 Mar;152(3):459‑61.
  6. Farzaneh E, Mehrpour O, Alfred S, Moghaddam HH, Behnoush B, Seghatoleslam T. Self-poisoning suicide attempts among students in Tehran, Iran. Psychiatr Danub. mars 2010 Mar;22(1):34‑8.
  7. Ferrer L, Kirchner T. Suicidal tendency in a sample of adolescent outpatients with Adjustment Disorder: Gender differences. Compr Psychiatry. 2014 Aug;55(6):1342‑9.
  8. Gould MS, Fisher P, Parides M, Flory M, Shaffer D. Psychosocial Risk Factors of Child and Adolescent Completed Suicide. Arch Gen Psychiatry. 1996 Dec;53(12):1155-62.
  9. Hetrick SE, Parker AG, Robinson J, Hall N, Vance A. Predicting suicidal risk in a cohort of depressed children and adolescents. Crisis. 2012 Jan 1;33(1):13‑20.
  10. Johnson JG, Cohen P, Gould MS, Kasen S, Brown J, Brook JS. Childhood Adversities, Interpersonal Difficulties, and Risk for Suicide Attempts During Late Adolescence and Early Adulthood. Arch Gen Psychiatry. 2002 Aug;59(8):741-9.
  11. Coskun M, Zoroglu S, Ghaziuddin N. Suicide rates among Turkish and American youth: a cross-cultural comparison. Arch Suicide Res. 2012;16(1):59‑72.
  12. Bhugra D. Suicidal behavior in South Asians in the UK. Crisis. 2002;23(3):108‑13.
  13. Casey P, Jabbar F, O’Leary E, Doherty AM. Suicidal behaviours in adjustment disorder and depressive episode. J Affect Disord. 2015 Mar 15:174:441-6.
  14. Polyakova I, Knobler HY, Ambrumova A, Lerner V. Characteristics of suicidal attempts in major depression versus adjustment reactions. J Affect Disord. 1998 Jan;47(1-3):159-67.
  15. Grudnikoff E, Soto EC, Frederickson A, Birnbaum ML, Saito E, Dicker R, et al. Suicidality and hospitalization as cause and outcome of pediatric psychiatric emergency room visits. Eur Child Adolesc Psychiatry. 2015 Jul;24(7):797-814.
  16. Magat RC, Guerrero APS. Suicidal behavior trends in a pediatric population in Hawai’i. Hawaii Med J. 2008 Mar;67(3):69-73.
  17. Wai BH, Hong C, Heok KE. Suicidal behavior among young people in Singapore. Gen Hosp Psychiatry. 1999 Mar-Apr;21(2):128-33.
  18. Mitrev I. A study of deliberate self-poisoning in patients with adjustment disorders. Folia Med (Plovdiv). 1996;38(3‑4):11‑6.
  19. Stewart JW, Quitkin FM, Klein DF. The pharmacotherapy of minor depression. Am J Psychother. 1992 Jan;46(1):23-36.