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      Use of Alcohol and Unprescribed Drugs after Suicide Bereavement: Qualitative Study

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          Abstract

          Studies describing the impact of suicide bereavement report an excess risk of suicide, suicide attempt, psychiatric illness, and drug and alcohol use disorders compared with the general population. However, the nature of patterns of drug and alcohol use after suicide bereavement is unclear. We used an online survey to collect qualitative data to understand whether and how drug and alcohol use changes after suicide bereavement. We conducted thematic analysis of free-text responses to a question capturing their use of alcohol and drugs after the suicide of a family member or a close friend. Analysing data from 346 adults in Britain aged 18–40, we identified three main themes describing the relationship of suicide bereavement to alcohol or drug use: (1) control over drug or alcohol use, (2) the perceived purpose of using drugs or alcohol, and (3) the attribution of drug or alcohol misuse to external factors. Overlying these themes were dimensions of control and of awareness of potential harms. This study highlights that increased use of drugs and alcohol after suicide bereavement may form part of a bereaved person’s coping strategies, and that sensitive approaches are needed when judging whether and when to intervene.

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          Most cited references30

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              Health outcomes of bereavement.

              In this Review, we look at the relation between bereavement and physical and mental health. Although grief is not a disease and most people adjust without professional psychological intervention, bereavement is associated with excess risk of mortality, particularly in the early weeks and months after loss. It is related to decrements in physical health, indicated by presence of symptoms and illnesses, and use of medical services. Furthermore, bereaved individuals report diverse psychological reactions. For a few people, mental disorders or complications in the grieving process ensue. We summarise research on risk factors that increase vulnerability of some bereaved individuals. Diverse factors (circumstances of death, intrapersonal and interpersonal variables, ways of coping) are likely to co-determine excesses in ill-health. We also assess the effectiveness of psychological intervention programmes. Intervention should be targeted at high-risk people and those with complicated grief or bereavement-related depression and stress disorders.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                24 October 2019
                November 2019
                : 16
                : 21
                : 4093
                Affiliations
                [1 ]UCL Division of Psychology and Language Sciences, 26 Bedford Way, London WC1H 0AP, UK; j.eng.17@ 123456alumni.ucl.ac.uk
                [2 ]UCL Centre for Behaviour Change, Research Department of Clinical, Educational, and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; lauren.drabwell.17@ 123456ucl.ac.uk
                [3 ]UCL Research Department of Primary Care & Population Health, Rowland Hill St, London NW3 2PF, UK; f.stevenson@ 123456ucl.ac.uk
                [4 ]UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK; michael.king@ 123456ucl.ac.uk (M.K.); d.osborn@ 123456ucl.ac.uk (D.O.)
                [5 ]Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK
                Author notes
                [* ]Correspondence: a.pitman@ 123456ucl.ac.uk ; Tel.: +44-20-7679-9467
                Author information
                https://orcid.org/0000-0002-9742-1359
                Article
                ijerph-16-04093
                10.3390/ijerph16214093
                6862291
                31652934
                60159bb6-625f-416d-a122-0d17dff7b69b
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 September 2019
                : 21 October 2019
                Categories
                Article

                Public health
                suicide,bereavement,grief,alcohol,drug,qualitative research,thematic analysis
                Public health
                suicide, bereavement, grief, alcohol, drug, qualitative research, thematic analysis

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