Transitions to, and correlates of, suicidal ideation, plans, and unplanned and planned suicide attempts among 3,729 men and women with alcohol dependence.
OBJECTIVE
Using a heuristic model of suicidal ideation and behavior, the two objectives were to identify correlates of (1) unique suicide-related outcomes (ideation, planning, planned attempt, unplanned attempt) and (2) specific transitions from one suicide-related category to the next.


METHODS
Analyses were conducted with data from the Collaborative Study on the Genetics of Alcoholism (COGA), a six-site family pedigree study of individuals in treatment for alcoholism, their relatives, and control families. There were 3,729 subjects in the analysis; all were age 18 years or older with a diagnosis of current alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Lifetime suicidal ideation, planning, and attempts were analyzed retrospectively. Correlates of each lifetime transition were analyzed using a series of multivariate logistic regressions. Multivariate multinomial regression analysis was used to examine correlates of each lifetime outcome.


RESULTS
Female gender is uniquely associated with transitions to unplanned and planned attempts. Independent depression and substance-induced depression are associated with transitions to ideation and planning, whereas alcohol-related aggression is correlated with transitions to unplanned attempts. Analyses of suicide-related outcomes show that women are at higher risk for unplanned and planned attempts. Substance use and impairment are related to suicidal plans and attempts but not ideation. Independent and substance-induced depressions are associated with each suicide-related outcome, whereas alcohol-related aggression is uniquely related to unplanned attempts.


CONCLUSIONS
Data underscore the heterogeneity of suicidal ideation and behavior among alcoholics and indicate the need to make clear distinctions between types of suicidal ideation and behavior in research and prevention efforts.
Conner
Kenneth R
KR
Center for the Study and Prevention of Suicide and the Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, New York 14620, USA.
Hesselbrock
Victor M
VM
Meldrum
Sean C
SC
Schuckit
Marc A
MA
Bucholz
Kathleen K
KK
Gamble
Stephanie A
SA
Wines
James D
JD
Kramer
John
J
D000328:Adult; D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D000987:Antisocial Personality Disorder / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010934:Planning Techniques; D012737:Sex Factors; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States