Shattered childhood: a key issue in suicidal behavior among drug addicts?

AIMS: To assess the relative importance of various adverse childhood experiences for the occurrence of later suicidal behavior in terms of experienced suicide attempts and suicidal ideation among drug addicts, and to assess possible gender differences in these associations.
DESIGN: Cross-sectional survey.
SETTING: Residential and outpatient treatment units for drug addicts in Norway. PARTICIPANTS: National sample of 800 drug addicts admitted to treatment in 1992-93. MEASUREMENTS: Self-reports of attempted suicide (life-time prevalence) and suicidal ideation (1 month prior to admission). Data collected from structured interviews with therapists.
FINDINGS: A total of 38.0% of the drug addicts reported having attempted suicide once or several times; the proportion was higher among those who reported various adverse experiences during childhood (sexual or violent assaults, bullying, parents' alcohol abuse, parents' psychiatric problems, school adjustment problems and own psychiatric problems), and increased with number of areas of such adverse childhood experiences. Forty-two per cent of the clients reported suicidal ideation in the month prior to admission, displaying the same kind of associations with adverse childhood experiences, and also a significant association when controlling for previous suicide attempts. There were relatively small gender differences in self-reported suicidal behavior, the proportion being somewhat higher among women, but only among those with no or few adverse childhood experiences.
CONCLUSIONS: Self-reported suicidal behavior and ideation among drug addicts is highly prevalent and more so with increasing number of areas of childhood adversities.