Leo Sher, M.D.
Our research article, “Objections to suicide among depressed patients with alcohol use disorders” was published 10 years ago in the October 2009 issue of the Journal of Affective Disorders (1).
In all, 521 mood disordered patients with and without alcohol use disorders were administered a battery of clinical measures including the Scale for Suicidal Ideation and the Reasons for Living Inventory. The Reasons for Living Inventory measures life-sustaining beliefs that would prevent someone from engaging in suicidal behavior. A multivariate analysis of covariance (MANCOVA) was conducted, examining the effects of alcohol use history on the Reasons for Living Inventory subscales and suicidal ideation, while controlling for differences in age, education, marital status and sex.
We found that Reasons for Living Inventory scores were not different between groups, except for the fact that patients with alcohol use disorders had fewer moral objections to suicide. Higher suicidal ideation was associated with lower moral objections to suicide scores. Prior suicidal behavior was associated with lower moral objections to suicide scores, and higher current suicidal ideation. A history of alcohol use disorders was not associated with suicidal ideation.
The fact that patients with alcohol use disorders had fewer objections to suicide, even though their level of current suicidal ideation was similar to those without alcohol use disorders indicates that attitudes about the acceptability of suicide may be conceptually distinguished from suicidal ideation, and may be differentially associated with suicide risk. A person who considers that suicide is acceptable may not endorse current suicidal ideation, but become resolutely suicidal following a subsequent crisis.
1.Richardson-Vejlgaard R, Sher L, Oquendo MA, Lizardi D, Stanley B. Objections to suicide among depressed patients with alcohol use disorders. J Affect Disord. 2009 Oct;117(3):197-201. doi: 10.1016/j.jad.2009.01.005.