Individuals with bipolar spectrum disorders (BSDs) tend to use alcohol and illicit substances at high rates, with alcohol, marijuana, and cocaine being the substances used most often. Similarly, those with BSDs are 10 times more likely to die by suicide and face reoccurring suicidal ideation (suicidal thoughts) which put them at continued risk for attempts in the future. While some studies have investigated the negative effects of using alcohol and substances on the likelihood that individuals will engage in a suicide attempt later, Prechter Program researchers from the Emotion and Temporal Dynamics (EmoTe) Lab wanted to see how the intensity (how much), the frequency (how often), and impairment (related problems) of alcohol and substance use were associated with suicidal ideation over time.
Using data from participants in the Prechter Longitudinal Study of Bipolar Disorder (PLS-BD) and intensive statistical modelling for longitudinal data, the researchers found that when an individual had more intense/frequent marijuana use and more substance and alcohol impairment than their usual, they experienced more suicidal ideation over the next six months. This occurred regardless of whether a person had an alcohol use disorder or substance use disorder. This work emphasizes that even small changes in alcohol and substance use may increase risk for suicidal ideation for those with BSDs.