title: Objections to suicide among depressed patients with alcohol use disorders.
abstract: BACKGROUND
  Understanding how alcohol misuse interacts with beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the Moral Objections to Suicide (MOS) subscale of the Reasons for Living Inventory (RFLI).
  
  
  METHODS
  521 mood disordered patients with and without alcohol use disorders (AUD) were administered a battery of clinical measures including the Scale for Suicidal Ideation and the Reasons for Living Inventory. A multivariate analysis of covariance (MANCOVA) was conducted, examining the effects of alcohol use history on the five RFLI subscales and suicidal ideation, while controlling for differences in age, education, marital status and sex.
  
  
  RESULTS
  RFL scores were no different between groups, except in one respect: patients with AUD had fewer moral objections to suicide. Higher suicidal ideation was associated with lower MOS scores. Prior suicidal behavior was associated with lower MOS, and higher current suicidal ideation. However, AUD history was not associated with suicidal ideation.
  
  
  CONCLUSIONS
  Patients with AUDs had fewer objections to suicide, even though their level of current suicidal ideation was similar to those without AUD, suggesting that attitudes about the acceptability of suicide may be conceptually distinguished from suicidal ideation, and may be differentially associated with risk for suicidal behavior. These findings suggest that alcohol use and suicidal behavior predict current attitudes toward suicide, however causal mechanisms are not clearly understood.
authors.affiliation: Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032, United States.
authors.forename: Randall
authors.initials: R
authors.lastname: Richardson-Vejlgaard
authors.forename: Leo
authors.initials: L
authors.lastname: Sher
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: Dana
authors.initials: D
authors.lastname: Lizardi
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D001293:Attitude to Death; D001714:Bipolar Disorder / Q000523:psychology*; D003469:Culture; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011340:Problem Solving; D011594:Psychometrics; D012941:Social Responsibility; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention