Changes in suicide rates after reductions in alcohol consumption and problems in Ontario, 1975-1983

Alcohol use and risk of suicide: a systematic review and Meta-analysis

Objectives: Alcohol use has several consequences and is one of the variables that increase risk of suicide. This meta-analysis was performed using cohort studies to clarify the association of alcohol use and suicide.Method: Scientific sources were reviewed regarding the keywords. After screening, thirty cohort studies were identified for the meta-analysis. The analysis was performed based on the random effects and subsequent analysis of the subgroups, based on various variables.Result: Analysis of the results showed that there is a relationship between alcohol use and suicide. Risk Ratio (RR) between alcohol use and suicide was 1.65. In men, pooled RR was 1.56 with 95% CI = 1.20-2.03, and in women, the pooled RR was equal to 1.40 with 95% CI = 1.11-1.77.Conclusion: Overall, the findings indicate that alcohol use is a risk factor for suicide. Therefore, it seems that prevention and control of alcohol use can be effective in promoting mental health.

Suicide in Australia: Do We Really Have A Problem?

In 1995, 2367 Australians lost their lives through suicide, and up to 100 times this number may attempt each year: Suicide has now become a major public health problem in Australia, which has seen the suicide rates in young males quadruple over the last 35 years or so. An analysis of current research on suicide and suicidal behaviour exploring possible causes and crosscultural issues, is discussed. As well, an extended definition of suicide as an intentional death and its antecedents provides the foundation for a discourse on the views now held by our corntemporary society. The paper argues that suicide not only is one of the most extreme consequences of personal psychosocial distress but also is often also an indicator of previous life events and environmental factors that potentiates for personal vulnerabilities.

Alcohol and Repeated Deliberate Self-Harm

Background: Repeated episode(s) of deliberate self-harm (RDSH) is a major risk factor for suicide. Aims: To identify specific risk factors for RDSH among patients admitted following an episode of deliberate self-harm (DSH) through acute intoxication. Methods: A prospective 6-month study was conducted with 184 patients (71% female) admitted to the emergency room (ER) as a result of self-poisoning (SP). Results: Rate of RDSH stood at 18% after 6 months. The sociodemographic variables associated with repeated deliberate self-harm were to have no principal activity, consultation with a medical professional during the 6 months preceding the self-poisoning, and referral to psychiatric services upon release from the ER. The clinical variable associated with RDSH was alcohol addiction (OR = 2.7; IC 95% = 1.2–6.1, p < .05) as assessed at the time of the initial ER admission. Conclusions: When patients are initially admitted to the ER as a result of self-poisoning, it is important to evaluate specific factors, particularly alcohol use, that could subsequently lead to repeated deliberate self-harm. The goal is to improve the targeting and referral of patients toward structures that can best respond to their needs.

Alcohol consumption predicts the EU suicide rates in young women aged 15-29 years but not in men: analysis of trends and differences among early and new EU countries since 2004

The aims of this study were to study suicide rates in youths aged 15-29 years in the European Union (EU), to identify differences between early members and new members to the EU since 2004, and to evaluate the association between alcohol-related variables and suicide rates, while controlling for indicators of social stress. We explored temporal trends in age-adjusted suicide rates for youths aged 15-29 years resident in EU nations since 1980. Social changes in EU nations were associated with increased inequalities between the countries in suicide, especially in male youths (new/early EU members: relative risk=1.55; 95% confidence interval: 1.48/1.61). Pure alcohol consumption predicts suicide rates in female youths, whereas social stress related to violence against youths predicts suicide rates in male youths. EU political and heath agencies should devise policies to prevent youth suicide with a focus on alcohol misuse and societal stress associated with violence against youths.

Addiction and suicidal behavior in acute psychiatric inpatients

OBJECTIVE

This study aims to evaluate the relationship of alcohol/drug use and effect severities to the degree of suicidality in acutely admitted psychiatric patients. Both degree of substance dependency and degree of substance-induced syndrome were analyzed. In addition, length of stay, involuntary status, and against medical advice discharge status were determined as they related to these variables.

METHODS

Structured clinical admissions and discharge ratings were gathered from 10,667 consecutive, single-case individual records, from an urban acute care county psychiatric hospital.

RESULTS

Data indicate that of the most severely suicidal group, 56% had substance abuse or dependence, 40% were rated as having half or more of their admission syndrome substance induced, and most had nonpsychotic diagnoses. There was an inverse relationship between degree of substance problem and length of stay. Although these patients more commonly left against medical advice, and were readmitted more frequently, they were less likely to be involuntarily committed.

CONCLUSIONS

A large, potentially lethal, and highly expensive subgroup of patients has been characterized, which might be called the "New Revolving Door acute psychiatric inpatient." This group, which uses the most expensive level of care in the mental health system but is substantially addiction related, poses special challenges for inpatient psychiatric units, addiction treatment providers, and health care planners.

Alcohol factors in suicide mortality rates in Manitoba

OBJECTIVE

To identify alcohol-related factors that influence mortality rates from suicide.

METHOD

We examined the impact of per capita consumption of total alcohol, spirits, beer, and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total, male and female suicide mortality rates in Manitoba during 1976 to 1997. Time series analyses with autoregressive integrated moving average modelling were applied to total, male and female suicide rates. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines.

RESULTS

Total alcohol consumption, and consumption of beer, spirits, and wine individually, were significantly and positively related to female suicide mortality rates. Spirits and wine were positively related to total and male mortality rates. AA membership rates were negatively related to total and female suicide rates. Unemployment rates were positively related to male and total suicide rates.

CONCLUSIONS

The data confirm the important relations between per capita consumption measures and suicide mortality rates. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and alcohol abuse treatment can exert beneficial effects observable at the population level.

THE ASSOCIATION BETWEEN ALCOHOL MISUSE AND SUICIDAL BEHAVIOUR

AIMS

Despite recent small reductions in overall suicide rates, rates among those aged 25-44 have remained high. The aim of this paper was to examine the evidence for a link between alcohol misuse/consumption and suicidal behaviour, explore the reasons for this association, and consider the implications for reducing rates of suicidal behaviour.

METHODS

A medline search was performed to find relevant research evidence.

RESULTS

There is evidence to suggest alcohol misuse predisposes to suicidal behaviour through its depressogenic effects and promotion of adverse life events, and both behaviours may share a common genetic predisposition. Acute alcohol use can also precipitate suicidal behaviours through induction of negative affect and impairment of problem-solving skills, as well as aggravation of impulsive personality traits, possibly through effects on serotonergic neurotransmission.

CONCLUSIONS

Effective interventions for problem drinking may help reduce suicide rates. At a public health level, reducing overall alcohol consumption may be beneficial, and the measures shown to be most effective in this regard are those that aim to restrict availability of alcohol.

Alcohol and suicide at the population level--the Canadian experience

Studies suggest that the population level link between alcohol and suicide differs across countries and between men and women. The aim of this paper was to estimate the relationship between alcohol consumption and suicide in Canada and to put the results in a comparative perspective. The relationship was elucidated for whole Canada, different provinces and also separately for men and women. The total suicide rate in Canada increased significantly by around 4% as alcohol consumption increased by one litre per capita, suggesting that approximately 25 - 30% of Canadian suicides were related to alcohol. The relationship was stronger for women than for men. A significant effect was found in all provinces except from Quebec, but the overall regional variation was not statistically significant. In an international perspective, the relationship for women was somewhat weaker than in Sweden and Norway, but larger than in Finland, the United States and Southern European countries. For men, the association was similar to what is found in the United States and Finland, weaker than in Sweden, Norway and Russia but stronger than in Southern European countries. The results only partly support the idea that intoxication frequency explains national differences in this relationship. Possible explanations for the stronger association among women are also discussed.

Relationships between Beer, Wine, and Spirits Consumption and Suicide Rates in U.S. States from 1977 to 1988

Relationships between alcohol consumption and suicide rates were examined through an ecological study. Data on total apparent per capita alcohol consumption, as well as beer, wine, and spirits consumption, from 1977 to 1988 in each of the fifty U.S. states and District of Columbia were compared with suicide rates. It was found that total alcohol consumption was weakly but significantly related to suicide rate by univariate analysis ( r = 0.16, p < 0.01). Pearson correlation coefficients were 0.30, 0.12, and −0.01 for correlation of suicide rate with beer, wine, and spirits consumption, respectively. Over the twelve years, the magnitude of associations between total alcohol consumption and suicide varied with correlation coefficients of 0.29, 0.23, 0.09, and 0.11 for four three-year periods, 1977–79, 1980–82, 1983–85, and 1986–88, respectively. The association between beer consumption and suicide persisted over the whole period with correlation coefficients of 0.35, 0.31, 0.26, and 0.30, while that between wine and suicide did not. Associations were also examined by quartile of each alcohol's consumption. Significant inverse association was found for beer as well as total consumptions at the lowest quartile. However, at the highest quartile, beer and spirits consumption showed positive association with suicide. These data suggest a “U-shaped” curve relating suicide rate to alcohol consumption. By using 1980 census data with adjustment for confounding effects of socioeconomic factors, total alcoholconsumption was found to be positively associated with suicide especially at high consumption level. At low level consumption, beer showed an inverse association with suicide after controlling for confounding effects.

The relationship between alcohol use and mortality rates from injuries: a comparison of measures

Per capita consumption of alcohol has traditionally been considered to be the leading indicator of population levels of alcohol problems. However, some recent research suggests that this relationship may be weakening, and that drinking pattern measures may be preferable to per capita consumption as problem-level indicators. We compared the ability of per capita alcohol consumption and survey-based measures of alcohol use to predict deaths from injuries in Ontario, Canada, for the period 1977-1996. Per capita consumption and percentage of daily drinkers were significantly related to injury mortality, but percentage of drinkers and percentage of episodic heavy drinkers (those who drank five or more drinks on a drinking occasion) were not. Of the measures we examined, per capita consumption was the strongest indicator of mortality rates from injuries. However, the survey-derived measure of percentage of daily drinkers was similar to per capita consumption in ability to predict problem levels.