@article{ref1,
title="Comorbid depression and alcohol use disorders and prospective risk for suicide attempt in the year following inpatient hospitalization",
journal="Journal of affective disorders",
year="2015",
author="Britton, Peter C. and Stephens, Brady and Wu, Jing and Kane, Cathleen and Gallegos, Autumn and Ashrafioun, Lisham and Tu, Xin and Conner, Kenneth R.",
volume="187",
number="",
pages="151-155",
abstract="OBJECTIVE: The purpose of this study is to identify predictors of nonfatal suicide attempts in veterans discharged from acute hospitalization with depression and/or alcohol use disorder (AUD) diagnoses. We hypothesized that primary depression confers similar risk for attempt whether or not it is accompanied by secondary AUD, and that a suicide attempt in the prior year would confer greatest risk of the variables studied. <br><br>METHOD: Veteran Health Administration (VHA) patients discharged from acute inpatient hospitalization in 2011 with AUD and/or non-bipolar depression diagnoses (N=22,319) were analyzed using information from the computerized record system and national database on suicidal behavior. Proportional hazard regression models estimated unadjusted and adjusted hazard ratios (AHR) and confidence intervals (95% CI) for risk of a nonfatal attempt within one year following discharge. <br><br>RESULTS: As hypothesized, primary depression with secondary AUD [AHR (95% CI)=1.41 (1.04, 1.92)] and without secondary AUD [AHR (95% CI)=1.30 (1.00, 1.71)] conferred similar prospective risk for attempt (AUD without depression, reference). Although prior suicide attempt was associated with increased risk, acute care in &quot;general psychiatry&quot; during hospitalization [AHR (95% CI)=6.35 (3.48, 13.00)] conferred the greatest risk among the variables studied. Transfer to another inpatient setting reduced risk [AHR (95% CI=0.53 (0.34, 0.79). LIMITATIONS: Analyses were based on administrative data and did not include information on mortality. <br><br>CONCLUSION: When primary depression is severe enough to warrant inpatient hospitalization, a secondary diagnosis of AUD may not contribute additional prospective risk for nonfatal attempt. Within VHA, acute psychiatric care during hospitalization is a potential marker for increased risk for nonfatal attempt. Transfer to an additional inpatient setting may reduce risk for nonfatal attempt.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2015.08.029",
url="http://dx.doi.org/10.1016/j.jad.2015.08.029"
}