Alcohol abuse and suicidal behaviour in young and middle aged men: differentiating between attempted and completed suicide.
OBJECTIVE
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.


METHODS
A 25-year follow-up study by linking data from military conscription, inpatient treatment and death register.


METHODS
A cohort of 46,490 Swedish male conscripts born in 1950-51.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Rossow
I
I
National Institute for Alcohol and Drug Research, Oslo, Norway. ingeborg.m.rossow@sifa.no
Romelsjö
A
A
Leifman
H
H
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology