title: Adolescent alcohol use, suicidal ideation, and suicide attempts.
abstract: OBJECTIVE
  To examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year.
  
  
  METHODS
  Screening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001-2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants' levels of depressive symptoms, and demographic characteristics.
  
  
  RESULTS
  Logistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation.
  
  
  CONCLUSIONS
  This study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use.
authors.affiliation: Division of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington, Connecticut, USA. eschilling@uchc.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Schilling
authors.forename: Robert H
authors.initials: RH
authors.lastname: Aseltine
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Glanovsky
authors.forename: Amy
authors.initials: A
authors.lastname: James
authors.forename: Douglas
authors.initials: D
authors.lastname: Jacobs
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000523:psychology*; D002648:Child; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000639:trends*; D055815:Young Adult