Suicide risk in Egyptian male patients with substance use disorder with and without co-morbid personality disorders during COVID-19 pandemic: a cross-sectional and hospital-based study

Abstract Background Substance use disorder (SUD) is associated with an increased likelihood of experiencing suicidal ideations and behaviors. The unique circumstances brought by the COVID-19 pandemic have exacerbated these risks. This study aims to evaluate the level of suicidal risk in individuals with SUDs who were exposed to COVID-19 pandemic, the association between specific substances used with suicide risk and co-morbid personality disorders or traits. The current study is a cross-sectional, hospital-based study, in which demographic data and mental health measurements were collected from 160 male patients diagnosed with SUD from Okasha Institute of Psychiatry-Ain shams University addiction outpatient clinics and inpatient unit. A predesigned clinical sheet was utilized to gather socio-demographic and clinical data. The Structured Clinical Interview for DSM-IV (SCID-I) was applied to assess psychiatric disorders, and the SCID-II was used to evaluate personality disorders. The Addiction Severity Index (ASI) was employed to assess the severity of addiction, while the Columbia-Suicide Severity Rating Scale (C-SSRS) was used to measure suicide risk. Results The study included 160 patients with a mean age of 31.22 (± 7.40) years. The most prevalent personality disorders identified were antisocial (25.3%) and borderline (20%). Among the patients, 71.9% reported death wishes and ideations, and 19.4% had previous suicidal attempts. The results revealed significant associations between personality disorders, positive family history for SUD, polysubstance use, physical health, and COVID-19 exposure with heightened suicide risk ( p values: 0.004, 0.028, 0.001, 0.038, and 0.034 respectively). Conclusion Several factors were significantly associated with an increased suicidal risk among patients with SUD, including COVID-19 exposure, polysubstance use, medical co-morbidities, family or social issues and co-morbid borderline and antisocial personality disorders.