Profile of psychoactive substance consumption associated with risk levels of suicidal behavior in Argentine adolescents
DOI:
https://doi.org/10.17533/udea.rfnsp.e358005Keywords:
self-destructive behavior, psychoactive substance use, suicidal ideation, suicide attempts, substance-related disorders, adolescent healthAbstract
Objective: To identify the characteristics of psychoactive substance use associated with risk levels of suicidal behavior in Argentine adolescents.
Methods: Study based on the Argentine School Health Survey of 2018 as a secondary source, whose probabilistic sampling consisted of 56,981 schoolchildren aged 13 to 17 years. The 3 levels of suicidal behavior were analyzed (ideation, planning and attempt). The classification tree using automatic detection of chi-square interactions, the crude and adjusted Odds Ratio (OR) using binary logistic regression, sensitivity, specificity, and positive and negative predictive value were used.
Results: The overall frequency of suicidal ideation in the past 12 months was 21.50% (n = 11,962), while 17.30% (n = 9,734) had suicidal planning and 15.10% (n = 8,507) attempted suicide at least once during the same period. For suicidal ideation, planning and attempt, the most common profile of association was a history of cigarette smoking, amphetamine/methamphetamine use and drinking alcohol alone. Based on this profile, it was observed that for suicidal ideation, adolescents had an adjusted OR of 8.10 (95% CI = 5.22-10.55). The specificity was 99.11%; the positive predictive value was 63%; and the negative predictive value was 80%. For suicidal planning, adolescents had an adjusted OR of 7.13 (95% CI = 4.70-9.84). Specificity was 99.10%, with a positive predictive value of 60% and a negative predictive value of 83%. For suicide attempt, adolescents had an adjusted OR of 8.14 (95% CI = 5.69-10.64). Specificity was 99.80%, with positive and negative predictive values of 62% and 85%, respectively.
Conclusions: This research provides evidence of the strong association between solitary alcohol consumption, amphetamine/methamphetamine use, and smoking with suicidal behavior in Argentine adolescents. ¿Furthermore, smoking predisposes adolescents to the use of psychostimulants. The importance of developing preventive strategies and public policies to reduce this behavior in adolescents is highlighted.
Downloads
References
1. Moutier C. Conducta suicida. En: Manual MSD versión para profesionales [internet]. 2023 [citado 2024 dic. 6]. Disponible en: https://www.msdmanuals.com/es/professional/trastornos-psiqui%C3%A1tricos/conducta-suicida-y-autoagresi%C3%B3n/conducta-suicida
2. Goodfellow B, Kõlves K, De Leo D. Contemporary definitions of suicidal behavior: A systematic literature review. Suicide Life Threat Behav. 2019;49(2):488-504. DOI: http://dx.doi.org/10.1111/sltb.12457
3. Soreff SM, Basit H, Attia FN. Suicide Risk. StatPearls Publishing [internet]; 2023 [citado 2024 ago. 4]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK441982/
4. Wisłowska-Stanek A, Kołosowska K, Maciejak P. Neurobiological basis of increased risk for suicidal behaviour. Cells. 2021;10(10):2519. DOI: http://dx.doi.org/10.3390/cells10102519
5. United Nations Office on Drugs and Crime (UNODC). UNODC World drug report 2022 [internet]; 2022. [citado 2024 ago. 2]. Disponible en: https://reliefweb.int/report/world/unodc-world-drug-report-2022
6. De la Torre-Luque A, Ozeylem F, Essau CA. Prevalence of addictive behaviours among adolescents from 73 low-and middle-income countries. Addict Behav Rep. 2021;14:100387. DOI: http://dx.doi.org/10.1016/j.abrep.2021.100387
7. Hong SW, Teesdale-Spittle P, et al. A review of monoamine oxidase (MAO) inhibitors in tobacco or tobacco smoke. Neurotoxicology. 2022;93:163-72. DOI: http://dx.doi.org/10.1016/j.neuro.2022.09.008
8. University of Montreal. Cocaine, amphetamine users more likely to take their own lives. Science Daily [internet]. 2014 dic. 16 [citado 2024 ago. 2]. Disponible en: https://www.sciencedaily.com/releases/2014/12/141216100638.htm
9. Ledden S, Moran P, et al. Alcohol use and its association with suicide attempt, suicidal thoughts and non-suicidal self-harm in two successive, nationally representative English household samples. BJPsych Open. 2022;8(6):e192. DOI: http://dx.doi.org/10.1192/bjo.2022.594
10. Gémes K, Forsell Y, Janszky I, et al. Moderate alcohol consumption and depression – a longitudinal population‐based study in Sweden. Acta Psychiatr Scand. 2019;139(6):526-35. DOI: http://dx.doi.org/10.1111/acps.13034
11. García-Pérez Á, Aonso-Diego G, et al. Testing the cannabis gateway hypothesis in a national sample of Spanish adolescents. Addict Behav. 2023;144:107751. DOI: http://dx.doi.org/10.1016/j.addbeh.2023.107751
12. Álvarez Bravo MC. Relación entre el consumo de alcohol y el suicidio en adolescentes y jóvenes [trabajo de fin de grado]. Universidad de las Illes Balears [internet]; 2022 [citado 2024 jul. 30]. Disponible en: https://dspace.uib.es/xmlui/bitstream/handle/11201/165005/Alvarez_Bravo_MariadelCarmen.pdf?sequence=1
13. Escobar JC. Encuesta Mundial de Salud Escolar (EMSE): Información para la acción [Presentación]. En: 38.° Congreso Argentino de Pediatría. Buenos Aires [internet]; 2017 [citado 2025 feb. 24]. Disponible en: https://www.sap.org.ar/docs/Congresos2017/CONARPE/Martes%2026-9/dr_Escobar_encuesta_mundial.pdf
14. Argentina, Ministerio de Salud. Encuesta Mundial de Salud Escolar 2018. En: Datos abiertos [internet]; 2018 [citado 2024 jul. 30]. Disponible en: http://datos.salud.gob.ar/dataset/76d53a00-a42f-45c7-81be-197b6c357937/resource/943253e1-7525-43d9-9af1-a9fad2d9fb19/download/metodologia-encuesta-mundial-de-salud-escolar-2018-nacional.pdf
15. The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement [internet]. s. f. [citado 2025 feb. 24]. Disponible en: https://www.equator-network.org/reporting-guidelines/record/
16. Choi H-Y, Kim E-Y, Kim J. Prognostic factors in diabetes : Comparison of Chi-square automatic interaction detector (CHAID) decision tree technology and logistic regression. Medicine (Baltimore). 2022;101(42):e31343. http://dx.doi.org/10.1097/md.0000000000031343
17. Ye F, Chen Z-H, Chen J, et al. Chi-squared automatic interaction detection decision tree analysis of risk factors for infant anemia in Beijing, China. Chin Med J (Engl). 2016;129(10):1193-9. http://dx.doi.org/10.4103/0366-6999.181955
18. IBM Documentation. Nodo CHAID [internet]. 2021 [citado 2024 ago. 4]. https://www.ibm.com/docs/es/spss-modeler/saas?topic=nodes-chaid-node
19. World Medical Association (WMA). WMA declaration of Helsinki – Ethical principles for medical research involving human participants [Internet]. 2024 [citado 2025 feb. 24]. Disponible en: https://www.wma.net/policies-post/wma-declaration-of-helsinki/
20. Argentina, Ministerio de Salud. Metodología EMSE 2018 Nacional. En Datos Abiertos del Ministerio de Salud [internet]; 2021 [citado 2024 jul. 30]. Disponible en: http://datos.salud.gob.ar/dataset/base-de-datos-de-la-3-encuesta-mundial-de-salud-escolar-emse-con-resultados-nacionales-argentina/archivo/943253e1-7525-43d9-9af1-a9fad2d9fb19
21. Martinelli T, Candel MJJM, De Vries H, et al. Exploring the gateway hypothesis of e-cigarettes and tobacco: A prospective replication study among adolescents in the Netherlands and Flanders. Tob Control [internet]. 2023 [citado 2024 ago. 4]; 32(2):170-8. Disponible en: https://tobaccocontrol.bmj.com/content/32/2/170
22. Spear LP. Consequences of adolescent use of alcohol and other drugs: Studies using rodent models. Neurosci Biobehav Rev. 2016;70:228-43. DOI: http://dx.doi.org/10.1016/j.neubiorev.2016.07.026
23. Cho MS. Use of alcohol, tobacco, and caffeine and suicide attempts: Findings from a nationally representative cross-sectional study. J Prim Care Community Health. 2020;11. DOI: http://dx.doi.org/10.1177/2150132720913720
24. Jung M. The relationship between alcohol abuse and suicide risk according to smoking status: A cross-sectional study. J Affect Disord. 2019;244:164-70. DOI: http://dx.doi.org/10.1016/j.jad.2018.09.077
25. Rizk MM, Herzog S, et al. Suicide risk and addiction: The impact of alcohol and opioid use disorders. Curr Addict Rep. 2021;8(2):194-207. DOI: http://dx.doi.org/10.1007/s40429-021-00361-z
26. Creswell KG, Terry-McElrath YM, Patrick ME. Solitary alcohol use in adolescence predicts alcohol problems in adulthood: A 17-year longitudinal study in a large national sample of US high school students. Drug Alcohol Depend. 2022;238:109552. DOI: http://dx.doi.org/10.1016/j.drugalcdep.2022.109552
27. Schouten MJE, Ten Have M, Tuithof M, et al. Alcohol use as a predictor of the course of major depressive disorder: A prospective population-based study. Epidemiol Psychiatr Sci. 2023;32:e14. DOI: http://dx.doi.org/10.1017/s2045796023000070
28. Lee W-C, Fang S-C, Chen Y-Y, et al. Exploring the mediating role of methamphetamine use in the relationship between adverse childhood experiences and attempted suicide. Addict Behav. 2021;123:107060. DOI: http://dx.doi.org/10.1016/j.addbeh.2021.107060
Pompili M, Serafini G, Innamorati M, et al. Suicidal behavior and alcohol abuse. Int J Environ Res Public Health. 2010;7(4):1392-431. DOI: http://dx.doi.org/10.3390/ijerph7041392
Downloads
Published
How to Cite
License
Copyright (c) 2025 Universidad de Antioquia

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The contents of the articles are the responsibility of the authors
The editorial committee has editorial independence from the National School of Public Health "Héctor Abad Gómez" of the University of Antioquia.
The editorial committee is not responsible for aspects related to copying, plagiarism or fraud that may appear in the articles published in it.
When you are going to reproduce and disclose photographs or personal data in printed or digital format, informed consent is required. Therefore, this requirement is required of the author at the time of receipt of the manuscript.
Authors are responsible for obtaining the necessary permissions to reproduce any material protected by reproduction rights.
The authors preserve the moral rights and assign the economic rights that will correspond to the University of Antioquia, to publish it, distribute electronic copies, include them in indexing services, directories or national and international databases in Open Access, under the Creative Commons Attribution license -Not Commercial-Share Equal 4.0 International Commercial (CC BY-NC-SA) which allows others to distribute, remix, retouch, and create from the work in a non-commercial way, as long as the respective credit and license are granted. new creations under the same conditions.
The authors will sign the declaration of transfer of economic rights to the University of Antioquia, after the acceptance of the manuscript.
The editorial committee reserves the right to reject the articles whose authors do not offer satisfactory explanations about the contribution of each author, to meet the criteria of authorship in the submission letter. All authors must meet the four criteria of authorship according to ICMJE: "a) .- That there is a substantial contribution to the conception or design of the article or to the acquisition, analysis or interpretation of the data. b) That they have participated in the design of the research work or in the critical review of its intellectual content. c) .- That has been intervened in the approval of the final version that will be published.d). That they have the capacity to respond to all aspects of the article in order to ensure that issues related to the accuracy or integrity of any part of the work are adequately investigated and resolved. "