title: Impact of acute alcohol consumption on lethality of suicide methods.
abstract: The influence of acute alcohol consumption on the factors related to suicide remains understudied. Thus, the present study investigated the relationship between blood alcohol content (BAC) and the lethality of suicide methods.
  
  
  
  Autopsy data on 315 South Korean suicide completers with a positive BAC were collected from a nationwide pool between May 2015 and November 2015, and the methods were dichotomised as suicide methods of low lethality (SMLL; drug/chemical overdose and sharp objects, n=67) and suicide methods of high lethality (SMHL; everything else, n=243). BAC at the time of autopsy and various suicide-related factors of these two groups were compared with logistic regression analyses.
  
  
  
  Compared to suicide completers with a BAC in the lowest range of 0.011-0.049%, suicide completers with a BAC in the range of 0.150-0.199% were more likely to use SMHL (odds ratio [OR]: 3.644, 95% confidence interval [CI]: 1.221-10.874). Additionally, the adoption of SMHL was significantly associated with the absence of a psychiatric illness (OR: 0.433, 95% CI: 0.222-0.843) and a younger age; the OR for high BAC among subjects in their 40s was 0.266 (95% CI: 0.083-0.856); in their 50s, 0.183 (95% CI: 0.055-0.615); and in their 60s, 0.057 (95% CI: 0.015-0.216).
  
  
  
  The relationship between BAC and suicide method lethality was represented by a bell-shaped pattern in which suicide methods of high lethality were more likely to be used by suicide completers with mid-range BAC levels. The increased impulsivity and impairments in particular executive functions, including planning and organization, associated with acute alcohol use may influence the selection of a particular suicide method based on its lethality.
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: hkpark@gmail.com.
authors.forename: C Hyung Keun
authors.initials: CHK
authors.lastname: Park
authors.affiliation: Institute of Forensic Medicine and Department of Forensic Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: yoosh@snu.ac.kr.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Yoo
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: jaewonlee08@gmail.com.
authors.forename: Jaewon
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: sjcho0812@hanmail.net.
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Cho
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: shinms@snu.ac.kr.
authors.forename: Min-Sup
authors.initials: MS
authors.lastname: Shin
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Mental Health Center, Seoul National University Health Care Center, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea. Electronic address: npeunyoung@gmail.com.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Dongguk University International Hospital, Dongguk University Medical School, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of Korea. Electronic address: sh3491@snu.ac.kr.
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Psychological Forensics Division, National Forensic Service, 10 Ipchun-ro, Wonju-si, Gangwon-do 26460, Republic of Korea. Electronic address: ksham@korea.kr.
authors.forename: Keunsoo
authors.initials: K
authors.lastname: Ham
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. Electronic address: aym@snu.ac.kr.
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood / Q000523:psychology*; D001344:Autopsy; D000067401:Blood Alcohol Content; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D056910:Republic of Korea; D013405:Suicide / Q000523:psychology*
chemical_list: D000067401:Blood Alcohol Content