Alcohol abuse and suicidal behaviour in young and middle aged men: differentiating between attempted and completed suicide
Aims. To establish whether alcohol abuse as a risk factor in suicidal behaviour would be different in parasuicide compared to completed suicide, and to explore the relative impact of alcohol abuse on completed suicide among parasuicides. Design. A 25-year follow-up study by linking data from military conscription, inpatient treatment and death register. Participants. A cohort of 46 490 Swedish male conscripts born in 1950-51. Measurements. Psychiatric diagnosis was recorded at conscription, diagnoses related to alcohol abuse and suicidal behaviour were recorded at any inpatient treatment during follow-up, and underlying cause of death was recorded for those who died during follow-up. Findings. Bivariate analyses showed alcohol abusers to have an elevated risk of attempted suicide (OR=27.1) as well as completed suicide (OR=4.7), but in the latter case to a significantly lesser extent. Correspondingly, alcohol abusers constituted a significantly larger proportion of the parasuicides (33.3%) than of the completed suicides (10.0%). A relatively stronger impact of alcohol abuse on parasuicide than on completed suicide remained after controlling for psychiatric co-morbidity, the adjusted odds ratios for attempted suicide and completed suicide being 8.8 and 2.4, respectively. Attempted suicide was a highly significant risk factor for completed suicide (OR=13.5). Among those who attempted suicide, alcohol abusers were found to have a significantly lower risk of completed suicide than other suicide attempters (OR=0.46). Conclusion. The significantly stronger association between alcohol abuse and attempted suicide compared to completed suicide may be viewed in the light of possible impact of intoxication and impulsiveness on non-fatal suicidal behaviour in alcohol abusers.
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Document Type: Research Article
Publication date: 1999-08-01