title: Suicidal behavior in alcohol-dependent subjects: the role of personality disorders.
abstract: BACKGROUND
  Comobidity of personality disorders (PDs) and alcohol dependence are considered to increase the risk for suicidal behavior. The aim of this study is to assess the influence of Diagnostic and Statistical Manual of Mental Disorder-fourth edition (DSM-IV) personality characteristics and comorbid axis I disorders on suicidal behavior in alcohol-dependent inpatients.
  
  
  METHODS
  Characteristics of alcohol dependence and suicidal behavior were obtained using the Semi-Structured Assessment on Genetics in Alcoholism (SSAGA). Personality disorder characteristics were assessed using the Structured Clinical Interview for DSM-IV Axis II Disorders.
  
  
  RESULTS
  Three-hundred seventy-six treatment-seeking alcohol-dependent subjects, of whom 55% were diagnosed to have a PD and approximately 25% had a history of at least 1 suicide attempt, were enrolled into the study. Subjects with PDs in all clusters reported a higher rate of suicide attempt history, depression episodes, and depression during the most serious attempt. As indicated by univariate and multivarate analysis, this pattern of suicide attempt characteristics was most pronounced in borderline disordered subjects and alcoholic individuals who live alone.
  
  
  CONCLUSIONS
  Subjects with alcohol dependence who have various comorbid PDs and depression deserve special attention in psychiatric care to prevent suicide. Psychotherapeutic strategies may have to be adapted to treat this high-risk population.
authors.affiliation: Department of Psychiatry, Ludwig-Maximilians Universität München, Germany. ulrich_preuss@hotmail.com
authors.forename: Ulrich W
authors.initials: UW
authors.lastname: Preuss
authors.forename: Gabriele
authors.initials: G
authors.lastname: Koller
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Markus
authors.initials: M
authors.lastname: Eikmeier
authors.forename: Michael
authors.initials: M
authors.lastname: Soyka
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D000704:Analysis of Variance; D001519:Behavior; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D000092864:Suicide Prevention