Leo Sher, M.D.

Our research report, “Effect of acute alcohol use on the lethality of suicide attempts in patients with mood disorders” was published 15 years ago in the July 2009 issue of the Journal of Psychiatric Research (1). We hypothesized that acute alcohol intoxication is associated with more lethal suicide attempts in patients with mood disorders. Therefore, we investigated the effect of acute alcohol intake on the lethality of suicide attempts in individuals with mood disorders.

In all, 317 suicide attempters with mood disorders were included in the study. The sample had a mean age of 37.1 years (SD = 12.0, range 18–85) and was 30.3% male. 194 study participants (61.2%) met criteria for major depressive disorder and 123 (38.8%) had bipolar disorder. The use of alcohol at the time of the most lethal suicide attempt was evaluated based on Item 19 of the Suicide Intent Scale, ‘‘Relationship between alcohol intake and attempt.” On the basis of their responses participants were classified into three groups: participants who reported “Enough alcohol intake to impair judgment, reality testing and diminish responsibility” or “Intentional intake of alcohol in order to facilitate implementation of attempt” were included in the group “Alcohol” (A); participants who reported “Some alcohol intake prior to but not related to attempt, reportedly not enough to impair judgment, reality testing” were included in the group “Some Alcohol” (SA); and participants who reported “No alcohol intake immediately prior to attempt” were included in the group “No Alcohol” (NA).

The lethality of the most lethal suicide attempts was higher in the A group compared to the SA and NA groups. Prevalence of patients with alcohol use disorders was higher in the A group compared to the SA and NA groups. SA participants reported more reasons for living and lower suicide intent scores at the time of their most lethal suicide attempt compared to the A and NA groups. The stepwise multiple regression model demonstrated that only the A group remained in the model which suggested that only the A group contributed significantly to the prediction of the lethality of suicide attempts. The results of our study indicated that acute alcohol use increases the lethality of suicide attempts in individuals with mood disorders.

Reference

1. Sher L, Oquendo MA, Richardson-Vejlgaard R, Makhija NM, Posner K, Mann JJ, Stanley BH. Effect of acute alcohol use on the lethality of suicide attempts in patients with mood disorders. J Psychiatr Res. 2009 Jul;43(10):901-5. doi: 10.1016/j.jpsychires.2009.01.005. Epub 2009 Feb 25.