Female Patients Show a Larger Reduction in Suicidal Ideation in Inpatient Addiction Treatment Than Male Patients: Results of a Single-Center Observational Study

Abstract

Background

Substance use disorders (SUD) are prevalent disorders worldwide. Among other associated health problems, patients with SUD are at an increased risk of dying of suicide, with females displaying an even higher risk than males. Therefore, the aim of this study was to conduct a gender-sensitive evaluation of changes in suicidal ideation during multimodal inpatient treatment at a hospital facility specialized in treating addiction.

Methods

A total of 694 patients (68.2% male) completed routine assessment including suicidal ideation, abstinence confidence, impulsivity, emotion regulation, self-efficacy and autonomy and joy both before (T1) and at the end (T2) of treatment. Mean changes were evaluated with repeated measures MANOVAs.

Results

Before treatment, a total of n=127 (18.3%) of the respondents reported suicidal ideation, which was reduced to n=72 (10.4%) by the end of treatment. Among female patients, the change in reported suicidal ideation compared from T1 to T2 (21.7% vs 7.7%) was significantly higher than among male patients (T1: 16.7%%, T2: 11.6%; p=0.040). Generally, females reported worse symptoms scores and slightly higher numbers of suicidal thoughts at baseline (effect sizes ranging from η²=.008 – 0.044). While both genders significantly profited from the treatment, female patients generally showed larger improvements than male.

Discussion

Our study underscores the beneficial effect of addiction-specialized inpatient treatment on suicidal ideation. Additionally, we found a substantial gender effect: while female patients generally were more distressed before treatment, they also reported higher symptom reduction during the treatment. This result highlights the need to perform more gender-sensitive research and develop more gender-sensitive treatment programs.

Keywords:

• addiction
• inpatient therapy
• alcohol
• drugs
• gender medicine

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Sigmund Freud University, Vienna (UBWCF2VXAVBDSV88362, vote on 16 December 2020).

Data Sharing Statement

The data sets analyzed in this manuscript are not publicly available due to ethical and legal restrictions (data contain potentially identifying and sensitive patient information). If not already reported within this work, the authors may provide descriptive data on individual medical indicators for admission and discharge or the expected change due to inpatient health care for various groups and diagnoses. Requests for access to anonymized data sets should be directed to the corresponding author Vincent Grote ([email protected]).

Informed Consent Statement

Written informed consent was obtained from all subjects involved in the study.

Acknowledgments

The authors sincerely thank Sara Crockett for proofreading support. We also want to thank Silvia Lechner for the organizational support of this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest in this work.