{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T04:42:59Z","timestamp":1766983379734,"version":"3.48.0"},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp;amp; Life Threat Behav"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Among patients with substance\u2010related disorders (\n                      <jats:styled-content style=\"fixed-case\">SRDs<\/jats:styled-content>\n                      ) and suicide attempts in 2014\u20132021, we identified care trajectories within a 3\u2010year period preceding their last suicide attempt (index date). We also determined associations between care trajectories and patients sociodemographic and clinical characteristics, quality of care received, and risk of death in the following year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Quebec (Canada) medical databases, we produced Group\u2010based Multi\u2010Trajectory Modeling, Multinomial Logistic Regression, and Cox Proportional Hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified five care trajectories (profiles) among the 2297 study patients. Profile 1 (31%, reference profile) had low outpatient care with late increase in acute care use. It included more men, younger patients and individuals with overall better conditions. Profile 2 (22%) received high physical healthcare and had more chronic physical illnesses. Profile 3 (19%), with more serious mental disorders, and Profile 4 (16%), with more polysubstance\u2010related disorders, used more outpatient mental health (\n                      <jats:styled-content style=\"fixed-case\">MH<\/jats:styled-content>\n                      ) or\n                      <jats:styled-content style=\"fixed-case\">SRD<\/jats:styled-content>\n                      care, decreasing before index date. Profiles 2, 3 and 4 increasingly used acute care before index date. Profile 5 patients (12%) had more health problems, and so showed the highest overall care use and highest risk of death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tailored interventions are suggested for all profiles, with improved screening and SRD\u2010MH care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sltb.70065","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:18:50Z","timestamp":1764159530000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Care Trajectories Among Patients With Substance\u2010Related Disorders in the 3\u2009Years Before Their Last Suicide Attempt"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4743-8611","authenticated-orcid":false,"given":"Marie\u2010Jos\u00e9e","family":"Fleury","sequence":"first","affiliation":[{"name":"Department of Psychiatry McGill University  Montreal Quebec Canada"},{"name":"Douglas Hospital Research Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhirong","family":"Cao","sequence":"additional","affiliation":[{"name":"Douglas Hospital Research Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Grenier","sequence":"additional","affiliation":[{"name":"Douglas Hospital Research Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elham","family":"Rhame","sequence":"additional","affiliation":[{"name":"Department of Medicine McGill University and Centre for Outcomes Research and Evaluation of the RI\u2010MUHC  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852924000373"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010019\u20106964\u20101"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000335"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010021\u201001460\u2010z"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2022.01.052"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010021\u201002217\u20107"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001145"},{"volume-title":"Validation d'un instrument d'\u00e9valuation de la gravit\u00e9 des probl\u00e8mes reli\u00e9s \u00e0 la consommation de drogues et d'alcool. L'indice de Gravit\u00e9 d'une Toxicomanie","year":"1992","author":"Bergeron J.","key":"e_1_2_12_9_1"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12873\u2010017\u20100126\u20105"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230397"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001888\u2010197510000\u201000006"},{"key":"e_1_2_12_13_1","unstructured":"Canadian Association of Emergency Physicians.2012.\u201cCanadian Triage Acuity Scale.\u201dhttps:\/\/caep.ca\/wp\u2010content\/uploads\/2017\/06\/module_I_slides_v2.5_2012.pdf."},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01246098"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102165"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229022"},{"volume-title":"Analysis of Survival Data","year":"1984","author":"Cox D. R.","key":"e_1_2_12_17_1"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291713000810"},{"volume-title":"Global Appaisal of Individual Needs (GAIN): Administration Guide for the GAIN and Related Measures (Version 5)","year":"2008","author":"Dennis M. L.","key":"e_1_2_12_19_1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2022.2066591"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010024\u201002674\u20100"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109511"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.112805"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16183274"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722\u2010018\u20100117\u20101"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061615"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2013.824841"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124101029003005"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/19371918.2013.774673"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20482"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010021\u201003089\u20102"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1027\/0227\u20105910\/a000001"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.08.100"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.2833"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13221"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1108\/IJPH\u201001\u20102020\u20100005"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000183"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011\u2010017\u20100111\u20108"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2022.2151959"},{"volume-title":"Group\u2010based modeling of development","year":"2005","author":"Nadin D.","key":"e_1_2_12_40_1"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100562"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216673085"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.29.4.05"},{"key":"e_1_2_12_45_1","unstructured":"Park\u2010Lee E. R. N.Lipari S. L.Hedden L. A.Kroutil andJ. D.Porter.2017.\u201cReceipt of Services for Substance Use and Mental Health Issues Among Adults: Results From the 2016 National Survey on Drug Use and Health NSDUH Data Review (Vol. September).\u201dSAMHSA.https:\/\/www.samhsa.gov\/data\/."},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1159\/000496742"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdv148"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1027\/0227\u20105910\/a000729"},{"key":"e_1_2_12_49_1","unstructured":"Public Health Agency of Canada.2020.\u201cSuiciide in Canada: Key Statistics.\u201dhttps:\/\/www.canada.ca\/content\/dam\/phac\u2010aspc\/documents\/services\/publications\/healthy\u2010living\/suicide\u2010canada\u2010key\u2010statistics\u2010infographic\/ENG.pdf."},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400178"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716639054"},{"volume-title":"Nombre de m\u00e9decins, montant total et montant moyen selon la cat\u00e9gorie de m\u00e9decins, le groupe de sp\u00e9cialit\u00e9s, la sp\u00e9cialit\u00e9 et le mode de r\u00e9mun\u00e9ration","year":"2017","author":"R\u00e9gie de l'assurance maladie du Qu\u00e9bec","key":"e_1_2_12_52_1"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406\u2010023\u201001716\u20105"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.09.021"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.730876"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010016\u20103706\u20105"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176344136"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.03.047"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000905"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12982\u2010015\u20100040\u20109"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400593"},{"volume-title":"Stata Statistical Software: Release 17","year":"2021","author":"StataCorp","key":"e_1_2_12_62_1"},{"volume-title":"Mental Illness and Stuctured Stigma in Canadian Health\u2010Care Settings: Results of a Focus Group Study","year":"2020","author":"Stuart H.","key":"e_1_2_12_63_1"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717714467"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2013.03.001"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201700475"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1080\/15504263.2020.1825892"}],"container-title":["Suicide and Life-Threatening Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sltb.70065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T04:38:17Z","timestamp":1766983097000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sltb.70065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":66,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/sltb.70065"],"URL":"https:\/\/doi.org\/10.1111\/sltb.70065","archive":["Portico"],"relation":{},"ISSN":["0363-0234","1943-278X"],"issn-type":[{"type":"print","value":"0363-0234"},{"type":"electronic","value":"1943-278X"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"assertion":[{"value":"2025-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70065"}}