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Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States

BACKGROUND: Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. OBJECTIVES: To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample...

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Autores principales: Oladunjoye, Adeolu Funso, Li, Elijah, Aneni, Kammarauche, Onigu-Otite, Edore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581466/
https://www.ncbi.nlm.nih.gov/pubmed/37847698
http://dx.doi.org/10.1371/journal.pone.0292922
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author Oladunjoye, Adeolu Funso
Li, Elijah
Aneni, Kammarauche
Onigu-Otite, Edore
author_facet Oladunjoye, Adeolu Funso
Li, Elijah
Aneni, Kammarauche
Onigu-Otite, Edore
author_sort Oladunjoye, Adeolu Funso
collection PubMed
description BACKGROUND: Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. OBJECTIVES: To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. METHODS: We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10–19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. RESULTS: 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3–1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). CONCLUSIONS: Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.
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spelling pubmed-105814662023-10-18 Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States Oladunjoye, Adeolu Funso Li, Elijah Aneni, Kammarauche Onigu-Otite, Edore PLoS One Research Article BACKGROUND: Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. OBJECTIVES: To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. METHODS: We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10–19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. RESULTS: 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3–1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). CONCLUSIONS: Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention. Public Library of Science 2023-10-17 /pmc/articles/PMC10581466/ /pubmed/37847698 http://dx.doi.org/10.1371/journal.pone.0292922 Text en © 2023 Oladunjoye et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Oladunjoye, Adeolu Funso
Li, Elijah
Aneni, Kammarauche
Onigu-Otite, Edore
Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title_full Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title_fullStr Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title_full_unstemmed Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title_short Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States
title_sort cannabis use disorder, suicide attempts, and self-harm among adolescents: a national inpatient study across the united states
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581466/
https://www.ncbi.nlm.nih.gov/pubmed/37847698
http://dx.doi.org/10.1371/journal.pone.0292922
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