Alcohol Use Disorders in Males who have Survived a Suicidal Attempt- A Cross-Sectional Study

Authors

DOI:

https://doi.org/10.30834/KJP.38.2.2025.515

Keywords:

Alcohol Use Disorder, Severity of Dependence, Intentional Self-harm , Suicidal Intent

Abstract

Background: Alcohol use disorders could be a major risk factor for suicidal behaviour. Our study aimed to find out the proportion of adults with Alcohol Use Disorder (AUD) in males who have survived a suicidal attempt and to find out the association of AUD and alcohol use-related factors with high suicidal intent.

Methods: This cross-sectional study of 230 consecutive male inpatients of age 18-70 years admitted with non-fatal suicidal attempt in consultation liaison psychiatry used a specifically designed proforma to get the socio-demographic, suicide, and alcohol use-related variables. The suicide intent was assessed using Beck’s Suicide Intent scale. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify AUD. The severity of Alcohol Dependence Questionnaire (SADQ) was used to assess the severity of AUD.

Results: 43.9 % of adult males with non-fatal suicidal attempt had AUD, and 15.2% had high suicidal intent, 63 (62.4%) had used alcohol on the day of the attempt, and 40 (39.6%) of them used alcohol before the attempt to facilitate the suicidal attempt. Of the patients with moderate or low suicidal intent, 75 (38.5%) had AUD, and 26 (74.3%) with high suicidal intent had AUD, which was found to be significant. (chi-square = 15.46, p = 0.001). Severity of alcohol dependence had a significant association with high suicidal intent (chi-square=4.46, p=0.03). Logistic regression after adjusting for confounders showed that AUD [Odds ratio= 4.18 (1.78-9.79); p=0.001] and severity of AUD [Odds ratio= 3.33 (1.33-8.30); p=0.01] remained significant risk factors for adult suicide attempts.

Conclusions: AUD was found to be significantly associated with high suicidal intent among adult males who have survived a suicidal attempt. Early recognition of risk factors for suicide, including alcohol use disorders and various alcohol use-related factors, helps in preventing suicides.

Downloads

Download data is not yet available.

References

Bhattacharjee S, Bhattacharya A, Thakurta RG, Ray P, Singh OP, Sen S. Putative effect of alcohol on suicide attempters: an evaluative study in a tertiary medical college. Indian J Psychol Med. 2012 Oct;34 (4):371-5. DOI: 10.4103/0253-7176.108224

Sreelatha P, Haritha G, Ryali VSSR, Janakiraman P. Alcohol use and its correlates in suicide attempters in a rural tertiary care teaching hospital in south India. Int J Res Med Sci 2019; 7:2387-93. DOI: 10.18203/2320-6012.ijrms20192534.

Conner KR, Duberstein PR. Predisposing and precipitating factors for suicide among alcoholics: empirical review and conceptual integration. Alcoholism: Clinical and Experimental Research. 2004; 28:6S–17S. DOI: 10.1097/01.ALC.0000127410.84505.2A

Sher L, Oquendo MA, Richardson-Vejlgaard R, Makhija NM, Posner K, Mann JJ, et al. Effect of acute alcohol use on the lethality of suicide attempts in patients with mood disorders. J Psychiatr Res. 2009 Jul; 43(10):901-5. DOI:10.1016/j.jpsychires.2009.01.005

The National Family Health Survey 2019-2021 (NFHS-5). Ministry of Health& Family Welfare. [Internet]. Govt of India 2022. [Cited 2025 July 18]. Available from: https://www.data.gov.in/catalog/national-family-health-survey-nfhs-5

Accidental Deaths & Suicides in India (ADSI). National Crime Record Bureau. Ministry of Home Affairs. [Internet]. Govt of India 2022. [Cited 2024 Apr 24]. Available from: https://ap.data.gov.in/catalog/accidental-deaths-suicides-india-adsi-2022.

Borges G, Bagge CL, Cherpitel CJ, Conner KR, Orozco R, Rossow I. A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychol Med. 2017 Apr; 47(5):949-957. DOI: 10.1017/S0033291716002841

Bowles T. Book Review: Diagnostic and statistical manual of mental disorders, fifth edition. Ment Health Clin [Internet]. 2013; 3(2):107. DOI:10.9740/mhc.n163617

Posner K, Melvin GA, Stanley B, Oquendo MA, Gould M. Factors in the assessment of suicidality in youth. CNS Spectr. 2007 Feb; 12(2):156-62. DOI: 10.1017/s1092852900020678

Remafedi G, French S, Story M, Resnick MD, Blum R. The relationship between suicide risk and sexual orientation: results of a population-based study. Am J Public Health. 1998 Jan; 88(1):57-60. DOI: 10.2105/ajph.88.1.57

Bohn MJ, Babor TF, Kranzler HR. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. J Stud Alcohol. 1995 Jul; 56(4):423-32. DOI: 10.15288/jsa.1995.56.423

AUDIT: the Alcohol Use Disorders Identification Test: guidelines for use in primary health care [Internet]. Who.int. [cited 2025 March 10]. Available from: https://www.who.int/publications/i/item/WHO-MSD-MSB-01.6a

Stockwell T, Murphy D, Hodgson R. The severity of alcohol dependence questionnaire: its use, reliability and validity. Br J Addict. 1983 Jun; 78(2):145-55. DOI: 10.1111/j.1360-0443.1983.tb05502.x

Lee J, Min S, Ahn JS, Kim H, Cha YS, Oh E, et al. Identifying alcohol problems among suicide attempters visiting the emergency department. BMC Psychiatry. 2019 Nov 8; 19(1):350. DOI: 10.1186/s12888-019-2347-5

Lejoyeux M, Huet F, Claudon M, Fichelle A, Casalino E, Lequen V. Characteristics of suicide attempts preceded by alcohol consumption. Arch Suicide Res. 2008; 12(1):30-8. DOI: 10.1080/13811110701800699

Dambrauskiene K, Adomaitiene V, Zalinkevicius R, Jariene G, Vilkas V, Rybakova I, Dunderiene L. Can Suicide Attempt be Related to Problem Drinking: Cohort Study? Alcohol 2019 Jan 1; 54(1):104-111. DOI: 10.1093/alcalc/agy080

Hsu WY, Chang TG, Chang CC, Chiu NY, Lin CH, Lane HY. Suicide Ideation among Outpatients with Alcohol Use Disorder. Behav Neurol. 2022 Feb 12; 2022:4138629. DOI: 10.1155/2022/4138629

Mini SS, Anuja U, Khan SS, Shameel KK.Prevalence of alcohol use among high school students, the pattern of consumption and the physical circumstances associated with alcoholism in an urban area of Kerala, India. Int J Community Med Public Health2017; 4:738-42. DOI: 10.18203/2394-6040.ijcmph20170750 (https://www.ijcmph.com/index.php/ijcmph/article/view/423/949)

Krystkiewicz M, Soyka M. Suicide Risk in Alcohol Use Disorders: Literature Review and Study Protocol with Preliminary Data for a Study in Treatment-Seeking Inpatients. Healthcare (Basel). 2025 Feb 28; 13(5):535. DOI: 10.3390/healthcare13050535

Pompili M, Serafini G, Innamorati M, Dominici G, Ferracuti S, Kotzalidis GD, et al. Suicidal behavior and alcohol abuse. Int J Environ Res Public Health. 2010 Apr; 7(4):1392-431. DOI: 10.3390/ijerph7041392

Kim AM. Alcohol consumption and suicide rate: A cross-sectional analysis in 183 countries. Psychiatry Res. 2021 Jan; 295:113553. DOI: 10.1016/j.psychres.2020.113553

Joshua AS, Anita, Joseph CM, Sainaba P. Substance use and Suicidal ideation among Adolescents in Kerala. Jour. of Ind Assoc for Child and Adol Ment Heal. 2021; 17 (4). 166-181. DOI:10.9740/mhc.n163617

Katuwal N, Shrestha DB, Adhikari SP, Oli PR, Budhathoki P, Amatya R, et al. Study on prevalence of suicidal ideation and risk factors of suicide among patients visiting psychiatric OPD at Shree Birendra Hospital, Kathmandu Nepal. PLoS One. 2021 Jul 20; 16(7):e0254728. DOI: 10.1371/journal.pone.0254728

Casey PR, Dunn G, Kelly BD, Birkbeck G, Dalgard OS, Lehtinen V, et al. Factors associated with suicidal ideation in the general population: five-centre analysis from the ODIN study. Br J Psychiatry. 2006 Nov; 189:410-5. DOI: 10.1192/bjp.bp.105.017368

Borges G, Bagge CL, Cherpitel CJ, Conner KR, Orozco R, Rossow I. A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychol Med. 2017 Apr; 47(5):949-957. DOI: 10.1017/S0033291716002841

Sher L. Alcoholism and suicidal behavior: a clinical overview. Acta Psychiatr Scand. 2006 Jan; 113(1):13-22. DOI: 10.1111/j.1600-0447.2005.00643.x

Mukamal KJ, Kawachi I, Miller M, Rimm EB. Drinking frequency and quantity and risk of suicide among men. Soc Psychiatry Psychiatr Epidemiol. 2007 Feb; 42(2):153-60. DOI: 10.1111/j.1600-0447.2005.00643.x

Quarshie EN, Waterman MG, House AO. Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review. BMC Psychiatry. 2020 May 14; 20(1):234. DOI: 10.1186/s12888-020-02587-z

Downloads

Published

04-11-2025

How to Cite

Arathy Nathan A, Lekshmy Gupthan, and Jaimon Plathottathil Michael. “Alcohol Use Disorders in Males Who Have Survived a Suicidal Attempt- A Cross-Sectional Study”. Kerala Journal of Psychiatry, Nov. 2025, doi:10.30834/KJP.38.2.2025.515.

Issue

Section

Research Report

Most read articles by the same author(s)