| Summary: | Crystal methamphetamine, a potent psychostimulant, presents a complex clinical landscape. However, insights into the predisposing factors for suicidal tendencies among Iraqi users remain limited. Our study delves into these risks among 165 patients. Rigorous multivariable analysis was conducted, employing binary logistic regression, drawing from patients from Baghdad Medical City and Ibn-Rushd Teaching Hospital. Most participants were in their third decade (26.62 ± 0.53 years). Regarding suicidal ideation, our model demonstrated robust accuracy, supported by the Hosmer–Lemeshow goodness-of-fit test (NagelKerke’s R<sup>2</sup> = 0.49, accuracy = 79.4%, <i>p</i> = 0.885). Notably, chronic methamphetamine use exceeding a year (OR = 6.15, <i>p</i> = 0.001), absence of psychological trauma (OR = 4.58, <i>p</i> = 0.006), and incidence of visual hallucinations (OR = 4.52, <i>p</i> = 0.001) rendered users more susceptible to suicidal ideation. Furthermore, our investigation unveiled risk factors tied to psychotic features and withdrawal manifestations. The study underscores pivotal predictors of suicidal ideation, warranting interdisciplinary vigilance from psychiatrists, clinical psychologists, and social workers. By monitoring at-risk individuals, progression toward the intricate spectrum of suicide can be potentially averted. These findings illuminate the urgency of tailored interventions for crystal methamphetamine users, contributing to enhanced holistic care.
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