Citation

Wojnar M, Ilgen MA, Jakubczyk A, Wnorowska A, Klimkiewicz A, Brower KJ. Drug Alcohol Depend. 2008; 97(3): 268-275.

Affiliation

Medical University of Warsaw, Department of Psychiatry, Nowowiejska 27, 00-665 Warsaw, Poland; Addiction Research Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109-5740, USA.

Copyright

(Copyright © 2008, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2008.04.006

PMID

18556146

PMCID

PMC3006072

Abstract

BACKGROUND: The present study was designed to examine the influence of suicidality on relapse in alcohol-dependent patients. Specifically, a lifetime suicide attempt at baseline was used to predict relapse in the year after treatment. Also, the unique contribution of impulsive suicide attempts was examined. METHODS: A total of 154 patients with alcohol dependence, consecutively admitted to four addiction treatment facilities in Warsaw, Poland participated in the study. Of the 154 eligible patients, 118 (76.6%) completed a standardized follow-up assessment at 12 months. RESULTS: Previous suicide attempts were common in adults treated for alcohol dependence with 43% patients in the present sample reporting an attempt at some point during their lifetime. Additionally, more than 62% of those with a lifetime suicide attempt reported making an impulsive attempt. Lifetime suicide attempts were not associated with post-treatment relapse (chi-square=2.37, d.f.=1, p=0.124). However, impulsive suicide attempts strongly predicted relapse (OR=2.81, 95% CI=1.13-6.95, p=0.026) and time to relapse (OR=2.10, 95% CI=1.18-3.74, p= 0.012) even after adjusting for other measures of baseline psychopathology, depression, impulsivity, hopelessness and alcohol use severity. CONCLUSIONS: This study is the first to document the relationship between pre-treatment impulsive suicide attempts and higher likelihood of post-treatment relapse in alcohol-dependent patents. Clinicians should routinely conduct an assessment for previous suicide attempts in patients with alcohol use disorders, and when impulsive suicidality isreported, theyshould recognizethe increased risk for relapse and formulate their patients'treatment plans accordinglywith thegoals of reducing both alcoholic relapseand suicide rates.

Language: en