title: Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis.
abstract: BACKGROUND
  Several original studies have investigated the effect of alcohol use disorder (AUD) on suicidal thought and behavior, but there are serious discrepancies across the studies. Thus, a systematic assessment of the association between AUD and suicide is required.
  
  
  METHODS
  We searched PubMed, Web of Science, and Scopus until February 2015. We also searched the Psycinfo web site and journals and contacted authors. We included observational (cohort, case-control, and cross-sectional) studies addressing the association between AUD and suicide. The exposure of interest was AUD. The primary outcomes were suicidal ideation, suicide attempt, and completed suicide. We assessed heterogeneity using Q-test and I2 statistic. We explored publication bias using the Egger's and Begg's tests and funnel plot. We meta-analyzed the data with the random-effects models. For each outcome we calculated the overall odds ratio (OR) or risk ratio (RR) with 95% confidence intervals (CI).
  
  
  RESULTS
  We included 31 out of 8548 retrieved studies, with 420,732 participants. There was a significant association between AUD and suicidal ideation (OR=1.86; 95% CI: 1.38, 2.35), suicide attempt (OR=3.13; 95% CI: 2.45, 3.81); and completed suicide (OR=2.59; 95% CI: 1.95, 3.23 and RR=1.74; 95% CI: 1.26, 2.21). There was a significant heterogeneity among the studies, but little concern to the presence of publication bias.
  
  
  CONCLUSIONS
  There is sufficient evidence that AUD significantly increases the risk of suicidal ideation, suicide attempt, and completed suicide. Therefore, AUD can be considered an important predictor of suicide and a great source of premature death.
authors.affiliation: Department of Clinical Psychology, Hamadan Branch, Islamic Azad University, Hamadan, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Darvishi
authors.affiliation: Department of Psychology, Faculty of Economics and Social Sciences, Bu-Ali Sina University Hamadan, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Farhadi
authors.affiliation: Department of Clinical Psychology, Hamadan Branch, Islamic Azad University, Hamadan, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Haghtalab
authors.affiliation: Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Jalal
authors.initials: J
authors.lastname: Poorolajal
mesh_terms: D019973:Alcohol-Related Disorders / Q000150:complications; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D017594:Publication Bias; D012044:Regression Analysis; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
chemical_list: D000431:Ethanol