Substance use and suicidal ideation and behaviour in low- and middle-income countries : a systematic review

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dc.contributor.authorBreet, Elsieen_ZA
dc.contributor.authorGoldstone, Danielen_ZA
dc.contributor.authorBantjes, Jasonen_ZA
dc.date.accessioned2018-04-30T05:23:17Z
dc.date.available2018-04-30T05:23:17Z
dc.date.issued2018-04-24
dc.date.updated2018-04-29T03:33:07Z
dc.descriptionCITATION: Breet, E., Goldstone, D. & Bantjes, J. 2018. Substance use and suicidal ideation and behaviour in low- and middle-income countries : a systematic review. BMC Public Health, 18:549, doi:10.1186/s12889-018-5425-6.
dc.descriptionThe original publication is available at https://bmcpublichealth.biomedcentral.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractBackground: Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs. Methods: We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist. Results: Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, nonfatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables. Conclusions: Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods.
dc.description.sponsorshipMedical Research Council
dc.description.sponsorshipNational Research Foundation (NRF)
dc.description.urihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5425-6
dc.description.versionPublisher's version
dc.format.extent18 pages
dc.identifier.citationBreet, E., Goldstone, D. & Bantjes, J. 2018. Substance use and suicidal ideation and behaviour in low- and middle-income countries : a systematic review. BMC Public Health, 18:549, doi:10.1186/s12889-018-5425-6
dc.identifier.issn1471-2458 (online)
dc.identifier.otherdoi:10.1186/s12889-018-5425-6
dc.identifier.urihttp://hdl.handle.net/10019.1/103974
dc.language.isoen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectSubstance abuseen_ZA
dc.subjectSuicidal behavioren_ZA
dc.subjectSuicide -- Preventionen_ZA
dc.titleSubstance use and suicidal ideation and behaviour in low- and middle-income countries : a systematic reviewen_ZA
dc.typeArticleen_ZA
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