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Citation
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Chin-Lun Hung G, Cheng CT, Jhong JR, Tsai SY, Chen CC, Kuo CJ. J. Clin. Psychiatry 2015; 76(12): 1687-1693. |
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Affiliation
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Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan. |
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Abstract
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OBJECTIVE: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population.
METHOD: We enrolled patients with alcohol dependence (ICD-9 code 303**) consecutively admitted to a psychiatric center in northern Taiwan from January 1, 1985, through December 31, 2008 (N = 2,793). Using patient linkage to the national mortality database (1985-2008), we determined that 960 patients died during the study period. Of those deaths, 65 patients died of suicide. On the basis of risk-set sampling for the selection of controls, we conducted a nested case-control study and collected the information by means of a standardized chart review process. We estimated the standardized mortality ratio (SMR) for suicide mortality. Conditional logistic regression was employed for exploring the risk and protective factors for suicide.
RESULTS: The study subjects had excessive suicide and all-cause deaths, with SMRs of 21.2 and 12.7, respectively. We pinpointed auditory hallucination (adjusted risk ratio [aRR] = 1.80, P =.04) and attempted suicide (aRR = 7.52, P =.001) as the risk factors associated with suicide. In contrast, protective factors included financial independence (aRR = 0.11, P =.005) and being married (aRR = 0.16, P =.02). Intriguingly, those with physical illnesses had a lower risk of suicide (aRR = 0.15, P =.01).
CONCLUSIONS: Compared with the general population, those with alcohol dependence faced excessive suicide mortality. For a comprehensive approach to suicide prevention, recognizing and improving the protective factors could have equal importance in mitigating the risk of suicide.
Language: en |