Suicide attempts in high-dose benzodiazepine users.

Area of Science:

• Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Substance use disorders are recognized risk factors for suicidal behavior.
• The association between high-dose regular benzodiazepine (BZD) use and suicidal behavior in individuals without a history of illegal substance abuse remains understudied.

Purpose of the Study:

• To investigate factors associated with a history of suicide attempts among high-dose regular BZD users (HDRUs).
• To differentiate the impact of high-dose BZD use versus comorbid psychiatric conditions on suicidal behavior.

Main Methods:

• A case-control study involving 55 HDRUs and two control groups (55 psychiatric patients matched for diagnosis and demographics, and 55 matched only for demographics).
• Exclusion of individuals with a history of illegal substance abuse.
• Logistic regression analysis to identify independent predictors of suicide attempts.

Main Results:

• HDRUs showed a significantly higher rate of past suicide attempts compared to demographic-matched controls (30.9% vs. 3.6%).
• No significant difference in suicide attempt history was found between HDRUs and diagnosis-matched controls (30.9% vs. 18.2%).
• Comorbid borderline personality disorder (BPD) was the sole independent predictor of a history of suicide attempts, irrespective of BZD dosage.

Conclusions:

• High-dose regular BZD use itself is not an independent predictor of suicide attempts in patients without a history of illegal substance abuse.
• Borderline personality disorder (BPD) is strongly associated with a history of suicide attempts in HDRUs.
• Clinical focus should be on identifying and managing comorbid BPD in high-dose BZD users to mitigate suicide risk.