الفهرس 
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Abstract
Patients and Methods Site of the Study: This study conducted in Neuropsychiatry Department and Psychiatry, Neurology and neurosurgery center, Tanta University. Subjects • Outpatient and inpatient patients with substance use disorders (35) and those had psychiatric disorder (35) who attended to of Neuropsychiatry Department. • (35) healthy persons attended with their relatives in the clinics Inclusion criteria: • from January 2019 to June 2019. • Age: 18:50 years old. • Males and Females. • Duration of illness: any duration of illness including newly diagnosed patients Exclusion Criteria: • Patients with medical comorbidity or neurological disorders. • Patients under 18 or above 50 years old. Methods and Procedures: All subjects in three groups (healthy, addicted, and psychiatric) were subjected to: 1) Socio-demographic data, present history, medical history, family history, and present mental state examination with emphasis on the substance use history. 2) Structure Clinical Interview for DSM5 disorder (SCID-5-CV) including: 3) Addiction Severity Index Arabic version. 4) Suicide probability scale (SPS) (Gull and Gill, 1982) Arabic version. 5) The Beck Depression Inventory-Arabic Version (BDI-II): lf-Harm diagnosis Scale for Adolcence and Adults. 6) Barratt’s impulsiveness scale. 7) Hamilton Anxiety Rating Scale for Anxiety. 8) Scale of Positive and negative Syndrome scale (PANSS). Globally, people with substance use disorder (SUD) are at significantly greater risk of suicide compared with the general population. SUD is also widely recognised as an important modifiable risk factor for suicide , with 45% and 33% of those who died by suicide in England whilst in contact with services, having a history of alcohol or other substances respectively (Padmanathan et al., 2020). In addition, the world health organization (WHO) noticed the association between suicide and mental disorders (in particular, depression and alcohol use disorders). Considering this, some researchers have noted that around 40% of patients in treatment for substance use disorders report a history of previous suicide attempts (Rodríguez-Cintas et al., 2018). Substance use is a recognized risk factor for self-harm (i.e., intentional and non-intentional self-injury with or without intent to die) and completed suicide. (Hawton et al., 2012) Among emergency department patients who presented with selfinflicted injury, 60.7% had a substance abuse diagnosis. (Darvishi et al., 2015) There are numerous biopsychosocial mechanisms, which may contribute to the increased risk of suicide amongst people with SUD. These include: 1) SUD leading to unemployment, social isolation and marginalisation; 2) substance use influencing cognition and behaviour, which may result in disinhibition and impulsivity; and 3) pain, distress and psychiatric conditions increasing the likelihood of both SUD and suicide (Esang and Ahmed, 2018). Research on both direct and indirect self-injury suggests that NSSI, SSI (Suicidual self-injury), and substance use are associated with several mental health concern, including both internalizing behaviors (e.g., depressive symptoms, anxiety symptoms and low self-esteem) and externalizing behaviors (e.g., aggressive behavior and criminal activity) (Andrews et al., 2012). Results • Age: average age was mainly between 31 – 40 years old. • Gender: 91.4% of normal group was males, all addiction group were males, and 94.3% of psychiatric group were males. • Education: Majority of subjects in the three groups were university educated. • Working status: Majority of subjects in the three groups were not working (unemployed). • Depression: about 28.6%of normal group subjects had no depression. 17.1% of addiction group subjects had mild depression, 42.9% of them had severe degree of depression. 65.7% of psychiatric group had moderate depression, while 17.1% had severe depression. • Anxiety: 37.1% of normal group subjects had mild anxiety, 5.7% had moderate anxiety. 54.3% of addict. group had moderate anxiety, 5.7% had severe anxiety. 34.3% of psycht. group had moderate anxiety, while 2.9% of them had severe anxiety. • Self-harming: no severe self-harm was observed in the three groups, while 60% of addict, and 42.9% psycht, groups had moderate self-harm levels. • Suicide probability: 22.9% of normal group subjects had mild Suicide probability. All (74.3%) subjects in addiction group had severe level of suicide probability. 51.4% of psycht. group had moderate level of suicide probability, and 22.9% of them had severe level of suicide probability. • Addiction severity index (ASI): 37.1% of addict group had considerable problem, while 37.1% had extreme problem majority of normal subjects had no problem. 13.3% of addict. Subjects had considerable problem, while majority (86.7%) of them had extreme problem. • Impulsivity: 54.3% of normal subjects had no impulsivity, while 40% of them had mild impulsivity. 74.3% of Subjects in addiction group had moderate impulsivity, 14.3% of them had severe impulsivity. 40% of Subjects in psycht. group had moderate impulsivity, 11.4% of them had severe impulsivity. • Self-harm and suicide probability was more probable among single females persons. ASI was more among males. • Results indicated significant correlation between suicide and ASI(r=0.488, p = 0.00).