title: Suicide attempts among alcohol-dependent pain patients before and after an inpatient hospitalization.
abstract: This study examined (1) whether pain diagnoses were risk factors for non-fatal suicide attempts before and after inpatient hospitalizations in alcohol-dependent veterans, and (2) the characteristics of pain patients who attempted suicide.
  
  
  
  Administrative data from the Veterans Health Administration were used to identify veterans with an alcohol use disorder who had an inpatient hospitalization during fiscal year 2011 (n=13,047). Logistic regression analyses were used to examine the associations of suicide attempts before and after hospitalizations with pain diagnoses, demographics, medical comorbidity, and psychiatric comorbidity.
  
  
  
  Bivariate analyses and analyses controlling for demographics and medical comorbidity, indicated that pain diagnoses were significantly associated with suicide attempts in the 365days before hospitalization (Odds Ratio Adjusted [OR]=1.22). This effect was not significant after controlling for psychiatric disorders. Pain diagnoses were not identified as risk factors of suicide attempts in the 365days following discharge. Subgroup analyses among only those with a pain diagnosis revealed that being younger (OR=2.64), being female (OR=2.28), and having an attempt in the year prior to hospitalization (OR=4.11) were risk factors of suicide attempts in the year following hospitalization. Additionally, younger age (OR=2.13) and depression (OR=3.53) were associated with attempts in the year prior to the hospitalization.
  
  
  
  This study suggests that psychiatric disorders account for the relationship between pain diagnoses and past suicide attempts among hospitalized alcohol-dependent veterans. Pain-specific suicide prevention efforts may be better targeted at less intensive levels of care.
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, USA. Electronic address: Lisham.Ashrafioun@va.gov.
authors.forename: Lisham
authors.initials: L
authors.lastname: Ashrafioun
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA. Electronic address: Cathleen.Kane@va.gov.
authors.forename: Cathleen
authors.initials: C
authors.lastname: Kane
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA. Electronic address: Brady.Stephens@va.gov.
authors.forename: Brady
authors.initials: B
authors.lastname: Stephens
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, USA. Electronic address: Peter.Britton@va.gov.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Britton
authors.affiliation: VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, USA; Department of Emergency Medicine, University of Rochester Medical Center, 265 Crittenden Blvd. Rochester, NY 14642, USA. Electronic address: Kenneth_Conner@urmc.rochester.edu.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Conner
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
keywords: Alcohol use disorder; Inpatient; Pain; Suicide attempts; Veterans