Recognition of adjustment disorder among patients with substance use disorders referred for suicide-related concerns in an academic hospital setting

Background: Persons with substance use disorders (SUDs) have a greater risk of suicide compared with the general population. Adjustment Disorder (AD) has been under-researched in SUD populations. Objective(s): To characterize rates, and associated features, of AD among persons with SUD for whom lethality concerns arise in a general hospital setting. Methods: Retrospective analysis of electronic medical record data from psychiatric consultations during a consecutive six-month period. Results: Compared with persons with SUD classified as non-attempters, suicide attempters were significantly more likely to be diagnosed with AD. Multiple logistic regression models revealed patients with SUD referred for suicide-related concerns have an increased risk of suicide attempt if also diagnosed with AD or if they have a history of prior suicide attempt. Conclusions: These data are in line with the contention that SUD, with comorbid AD, portend significant risk for suicide. AD represents an important disorder to recognize and target in suicide prevention strategies.