Predictors of attempted suicide among Swiss patients with alcohol-use disorders.
OBJECTIVE
Suicide attempts are common in patients being treated for alcohol-use disorders (AUDs). However, clinical assessment of suicide risk is difficult. In this Swiss multisite study, we propose a decision tree to facilitate identification of profiles of AUD patients at high risk for suicidal behavior.


METHODS
In this retrospective study, we used a sample of 700 patients (243 female), attending 1 of 12 treatment programs for AUDs in the German-speaking part of Switzerland. Sixty-nine patients who reported a suicide attempt in the 3 months before the index treatment were compared using risk factors with 631 patients without a suicide attempt. Receiver operating characteristic (ROC) analyses were used to identify patients at risk of having had a suicide attempt in the previous 3 months.


RESULTS
Consistent with previous empirical findings in AUD patients, a prior history of attempted suicide and severe symptoms of depression and aggression considerably increased the risk of a suicide attempt and, in combination, raised the likelihood of a prior suicide attempt to 52%. In addition, one third of AUD patients who had a history of suicide attempts and previous inpatient psychiatric treatment, or who were male and had previous inpatient psychiatric treatment, also reported a suicide attempt.


CONCLUSIONS
The empirically supported decision tree helps to identify profiles of suicidal AUD patients in Switzerland and supplements clinicians' judgments in making triage decisions for suicide management.
Buri
Caroline
C
University Hospital of Psychiatry Berne, Switzerland.
von Bonin
Beatrice
B
Strik
Werner
W
Moggi
Franz
F
D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology