As shown in , among both men and women, the most common drug use pattern was the use of both cocaine and opiates (49% in men vs. 47% in women), followed by the use of cocaine only (37% for both men and women). With the exception of the use of opiates without cocaine among women, no differences were found by gender in lifetime patterns of cocaine and opiate use. Women were slightly more likely than men to report a lifetime history of injection drug use (48% among women vs. 42% among men). Although not shown, female cocaine and opiate users were more likely than their male counterparts to meet criteria for either lifetime DSM-III-R opiate or cocaine dependence (91% vs. 84%; p = 0.042); thus, we determined that this more severe behavior would be used in the model instead of the cocaine or opiate use variables.
Lifetime Prevalence of Cocaine and Opiate Drug Use Among SARA/ERSA Sample (N = 990)
As shown in , women were statistically significantly more likely than men to meet criteria for DSM-III-R depressed mood (58% vs. 42%) and DSM-III-R depression (24% vs. 12%). Although women were twice as likely as men to be diagnosed with a depressive disorder, men were nearly twice as likely as women to meet DSM-III-R criteria for ASPD (42% vs. 24%). Additionally, three times as many women as men reported eight or nine depression criteria.
Lifetime History of Psychiatric Disorders of SARA/ERSA Sample (N = 987)
Suicidal ideation reported by men and women is shown in . Although a surprisingly high proportion of both men and women reported having at least one suicidal thought or behavior, this rate was statistically significantly higher among women than men (63% vs. 47%). Additionally, women were more likely than men to report thinking a lot about death (50% vs. 31%), feeling like they wanted to die (39% vs. 21%), thinking about committing suicide (47% vs. 33%), and actually attempting suicide (33% vs. 11%). More than three times as many women as men reported all four items. Although not shown, race/ethnicity and marital status were also associated with SI, without controlling for gender. Specifically, reporting at least one suicidal behavior was higher among African Americans than others (68% vs. 32%; χ2 = 28.32; p = 0.001), and those who had been married compared with never married (51% vs. 49%; χ2 = 6.58; p = 0.010).
Lifetime Suicidal Ideation Among SARA/ERSA Subjects (N = 990)
As shown in , male suicide ideators, compared with male nonideators, had statistically significantly higher rates of depressed mood (58% vs. 28%), DSM-III-R depression (23% vs. 1%), DSM-III-R ASPD (50% vs. 35%), and DSM-III-R alcohol abuse or dependence (77% vs. 59%). Female ideators, compared with female nonideators, also had statistically higher rates of depressed mood (72% vs. 34%), DSM-III-R depression (34% vs. 6%), and DSM-III-R alcohol abuse or dependence (68% vs. 38%), but not DSM-III-R ASPD. As shown in , male suicide ideators were significantly more likely than male nonideators to report both cocaine and opiate use (56% vs. 43%), to report an injection drug history (46% vs. 38%), and to meet criteria for cocaine abuse or dependence (69% vs. 60%). Surprisingly, female ideators versus nonideators did not differ significantly in their history of drug use, abuse, or dependence. Of note, female ideators, compared with male ideators, were fairly comparable in their drug use patterns.
Suicidal Ideation and Lifetime History of Psychiatric Disorders of SARA/ERSA Sample (N = 987)
Suicidal Ideation and Lifetime Drug History of SARA/ERSA Sample (N = 989)
A multiple logistic regression model was tested separately for men and women, controlling for race/ethnicity and age; educational, marital, parental, and employment status; arrest record; and abuse or dependence on alcohol, cocaine, or opiates (). In addition, history of ASPD and the number of DSM-III-R depression criteria were assessed. Men with alcohol abuse or dependence and ASPD were each 1.6 times more likely than their counterparts to report SI. The number of depression criteria was found to predict SI strongly. Specifically, men meeting only one criterion for depression were 1.57 times more likely than men meeting no criteria to report SI; if they reported three criteria, they were nearly four times more likely (OR = 3.83) to report SI; if they reported five criteria (the threshold for depression), they were 9.38 times more likely than men meeting no criteria to report SI; and if there were seven criteria reported, the OR was 23.51. There was a trend for men with an arrest history to be protected from reporting SI (OR = .66; 95% CI, .43–1.01).
Multiple Logistic Regression of Suicidal Ideation Among SARA/ERSA Sample (N = 990)
The picture for women was slightly different. Younger women and never-married women were less likely to report SI than older women and women who had been married. Additionally, women meeting criteria for alcohol abuse or dependence were nearly three times more likely than their counterparts to report SI (OR = 2.77). However, as for men, the number of DSM-III-R depression criteria met was found to predict SI strongly. For example, women meeting only one criterion were 1.56 times more likely than women meeting no criteria to report SI; women with three criteria were 3.77 times more likely than women without any to report SI; women crossing the diagnostic threshold (those with five criteria) were 9.12 times more likely to report SI than women without any criteria met; and women with seven criteria reported were 22.48 times more likely. Although female ideators and nonideators did not differ significantly on ASPD, the finding just missed statistical significance, with an association similar to that found for men (OR = 1.90).
Although not shown, we also tested a model in which the categorical variable depressed mood was substituted for the continuous variable number of depression criteria. For men, alcohol use disorders and ASPD predictors remained strong predictors of SI; further, depressed mood generated an odds ratio of 3.16 (95% CI, 2.25–4.43). For women, all but age remained in the model; however, there was also a trend for ASPD to be significant, whereas depressed mood reached an odds ratio of 4.73 (95% CI, 2.73–8.19).