A comprehensive model of predictors of suicide attempt in heavy drinkers: Results from a national 3-year longitudinal study

• Published in: Drug and alcohol dependence 2018-05, Vol.186, p.44-52
• Main Authors: Hoertel, Nicolas, Faiz, Hadi, Airagnes, Guillaume, Blanco, Carlos, Pascal De Raykeer, Rachel, Franco, Silvia, Ducoutumany, Géraldine, Lemogne, Cédric, Limosin, Frédéric
• Format: Article
• Language: English
• Subjects: Abuse; Adolescent; Adult; Alcohol abuse; Alcohol related disorders; Alcohol use; Alcohol use disorder; Alcoholic beverages; Alcoholism; Alcoholism - diagnosis; Alcoholism - psychology; Alcohols; Behavior disorders; Comorbidity; Correlation analysis; Dependence; Disorders; Drinking behavior; Drinks; Drug abuse; Epidemiology; Female; General population; Heavy drinking; Help seeking behavior; High risk; Humans; Liability; Longitudinal Studies; Male; Mathematical models; Mental disorders; Mental health care; Middle Aged; Models, Theoretical; Prevention; Psychiatric disorders; Psychopathology; Risk; Risk Assessment; Severity; Severity of Illness Index; Sociodemographics; Structural equation modeling; Substance use; Substance use disorder; Suicide; Suicide attempt; Suicide prevention; Suicide, Attempted - psychology; Suicides & suicide attempts; Treatment-Seeking; Young Adult
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2018.01.010

•We developed a comprehensive model of the risk of suicide attempt in heavy drinkers.•We used structural equation modeling in a nationally representative sample.•Several factors at baseline were associated with the 3-year risk of suicide attempt.•They included severity of alcohol use disorder and psychiatric comorbidity.•This model may help identify individuals with heavy drinking at high risk of suicide. Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001–2002; wave 2, 2004–2005). We used structural equation modeling to simultaneously examine effects of four broad groups of clinical factors previously identified as potential predictors of attempted suicides: 1) alcohol use disorder severity, 2) severity of comorbidity, 3) sociodemographic characteristics and 4) help-seeking for alcohol problems. Heavy drinking was defined as drinking 5 or more drinks in a day more than once a week in the month prior to Wave 1. About 1.5% of the 1573 heavy drinker participants (i.e., 5.1% of the NESARC sample) attempted suicide during the 3-year follow-up period. After adjusting for all other factors, several factors independently predicted attempted suicides: the alcohol use disorder liability factor measured by DSM-IV-TR criteria for alcohol abuse and dependence and two dimensions of psychopathology, the general psychopathology factor accounting for the shared effects of all comorbid psychiatric disorders and the externalizing dimension accounting for the shared effects of comorbid substance use disorders. No other factor predicted this risk in addition. This model may help identify individuals with heavy drinking at high risk of suicide and develop more effective suicide prevention strategies.