Triggers for suicidal behavior in depressed older adolescents and young adults: do alcohol use disorders make a difference?
Adolescent suicide is a major social and medical problem. Alcohol use disorders with comorbid major depression represent an especially high-risk profile for suicidal behavior, repeated suicidal behavior and completed suicide. We compared demographic and clinical characteristics, prevalence of interpersonal triggers and the number of triggers for suicidal behavior in depressed late adolescents and young adults with or without comorbid alcohol use disorders.


METHODS
18-26-year-old subjects were recruited through advertising and referrals and participated in mood disorders research in a university hospital. Thirty-eight depressed suicide attempters without a history of any alcohol or substance abuse/dependence and 29 depressed suicide attempters with comorbid alcohol abuse or dependence participated in the study. Demographic and clinical parameters including parameters related to suicidal behavior were examined and recorded.


RESULTS
There was no difference with regard to demographic parameters between the two groups. Depressed suicide attempters with comorbid alcohol use disorders had higher aggression and impulsivity scale scores and were more likely to be tobacco smokers compared to their counterparts without alcohol use disorders. Additionally, there was a trend towards higher lethality of suicide attempts in subjects with alcohol use disorders compared to the other group. We found no difference in the prevalence of interpersonal triggers or in the number of triggers for suicidal behavior between the two groups.


CONCLUSIONS
It appears that among 18-26-year-old depressed suicide attempters, individuals with comorbid alcohol use disorders are more impaired with regard to aggressiveness and impulsivity compared to persons without comorbid alcohol abuse/dependence.
Sher
Leo
L
Division of Neuroscience, Department of Psychiatry, Columbia University, New York, NY 10032, USA. LS2003@columbia.edu
Sperling
Dahlia
D
Stanley
Barbara H
BH
Carballo
Juan J
JJ
Shoval
Gal
G
Zalsman
Gil
G
Burke
Ainsley K
AK
Mann
J John
JJ
Oquendo
Maria A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000374:Aggression; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D000297:Psychology, Adolescent; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*