依存症は自殺リスクの上昇と関連(Addiction is linked to an increased risk of suicide)

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2026-09-23 カロリンスカ研究所(KI)

カロリンスカ研究所(Karolinska Institutet)の研究チームは、物質使用障害(アルコール・薬物などへの依存)と自殺行動との関連、およびその家族内集積をスウェーデンの全国登録データから分析した。1958~1999年生まれの約420万人を1973~2020年に追跡した結果、物質使用障害の診断を受けた人では、診断のない人に比べて自殺行動(自殺未遂または自殺死亡)のリスクが6倍超高かった。アルコールと薬物の双方に依存する人では関連が特に強く、約44%に自殺行動が記録された。また、物質使用障害のある人の近親者でも自殺行動が多く、遺伝的要因と家族内で共有される環境要因の双方が関与する可能性が示された。ただし、専門医療で診断された症例を中心とする観察研究であり、因果関係を証明するものではない。また、スウェーデンの登録データに基づくため、他国への一般化には注意が必要である。

<関連情報>

生涯にわたる物質使用障害と自殺行動:人口ベースの家族内共集積登録研究 Lifetime substance use disorder and suicidal behaviour: a population-based familial co-aggregation register study

Lotfi Khemiri, Ralf Kuja-Halkola, Henrik Larsson, Isabell Brikell, Zheng Chang, Brian M. D’Onofrio, Antti Latvala & Paul Lichtenstein
Molecular Psychiatry  Published:22 September 2026
DOI:https://doi.org/10.1038/s41380-026-03866-z

依存症は自殺リスクの上昇と関連(Addiction is linked to an increased risk of suicide)

Abstract

Substance use disorders (SUD) are associated with suicidal behaviour, but less is known regarding the extent to which familial factors influence these associations across different types of SUD. We performed a national register study including 4,209,615 individuals born in Sweden 1958–1999 and followed 1973–2020. Exposure was life-time SUD diagnosis, including alcohol use disorder (AUD), drug use disorder (DUD) or dual diagnosis (AUD + DUD). DUD was further classified into substance type (e.g., cannabis, opioids, sedatives or stimulants). Outcome was life-time suicidal event, operationalized as either suicide attempt or death by suicide. Log-linear regression models estimating risk ratios (RR) were fitted with adjustment for sex, birth year, socioeconomic factors and psychiatric co-morbidity. Of 258,046 individuals with SUD, 23.0% (n = 59,436) had any life-time suicidal event compared to 1.5% (n = 59,784) in 3,951,569 persons without SUD. SUD was associated with increased risk of any suicidal event (Adjusted RR: 6.4 [6.3–6.5]), suicide attempt (6.9 [6.8–7.0]) and suicide death (3.3 [3.2–3.5]). Elevated suicide risk was observed across all SUD, with greatest risk in those with AUD + DUD. Larger RR suicidal events were observed in relatives of individuals with SUD as genetic similarity increased (e.g., full siblings: 2.6 [2.6–2.7]; half siblings: 1.5 [1.5–1.6]). This pattern was observed for all types of SUD, with highest RR in individuals with AUD + DUD relatives (e.g., full siblings: 3.5 [3.4–3.6]; half siblings: 1.7 [1.7–1.8]). Our results suggest that SUD of all substances and suicidality share familial factors, with the clinical implication that family history of SUD constitutes a risk factor for suicidal behaviour.

有機化学・薬学
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