@article{ref1,
title="Circadian pattern of deaths due to suicide in intoxicated alcohol-dependent individuals",
journal="Journal of clinical psychiatry",
year="2018",
author="Chakravorty, Subhajit and Smith, Rachel V. and Perlis, Michael L. and Grandner, Michael A. and Kranzler, Henry R.",
volume="79",
number="6",
pages="17m11800-17m11800",
abstract="OBJECTIVE: Alcohol intoxication and dependence are risk factors for suicide, a leading cause of death in the United States. We examined the hours of peak and nadir in completed suicides over a 24-hour period among intoxicated, alcohol-dependent individuals. We also evaluated suicide-related factors associated with intoxication at different times of the day. <br><br>METHODS: We analyzed cross-sectional data from the 2003-2010 National Violent Death Reporting System provided by 16 US states. In the primary database, the deceased individuals' alcohol-dependent status was classified as &quot;yes&quot; or &quot;no or unknown.&quot; We restricted the analysis to alcohol-dependent individuals with alcohol level data available (N = 3,661). The primary outcome measure was the reported time of death. Secondary outcome measures were predisposing and injury-related factors. Individuals were classified on the basis of their blood alcohol level (BAL) as heavy drinking (BALH [≥ 80 mg/dL]) or non-heavy drinking (BALO [< 80 mg/dL]). The time of injury was divided into 1-hour bins, which were used to compute the incidence of suicide over 24 hours. We also evaluated the association between clinical factors and BALH for each of six 4-hour time periods beginning at 00:01 hours. <br><br>RESULTS: The majority (73.4%) of individuals showed evidence of alcohol consumption prior to committing suicide. BALH was observed in 60.7% of all individuals. Peak incidences in suicide were identified at 21:00 for BALH and 12:00 for BALO, with nadirs at 05:00 and 03:00 hours, respectively. In a multivariable analysis, between 20:01 and 00:00 hours, BALH was associated with more risk and protective factors than BALO. <br><br>CONCLUSIONS: Identifying critical times and associated risk factors for suicidal behavior may contribute to suicide prevention efforts in intoxicated alcohol-dependent individuals.<br><br>© Copyright 2018 Physicians Postgraduate Press, Inc.<p /> <p>Language: en</p>",
language="en",
issn="0160-6689",
doi="10.4088/JCP.17m11800",
url="http://dx.doi.org/10.4088/JCP.17m11800"
}