Impulsive and non-impulsive suicide attempts in patients treated for alcohol dependence (original) (raw)
Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients
Drug and Alcohol Dependence, 2008
Background: The present study was designed to examine the influence of suicidality on relapse in alcohol-dependent patients. Specifically, a lifetime suicide attempt at baseline was used to predict relapse in the year after treatment. Also, the unique contribution of impulsive suicide attempts was examined. Methods: A total of 154 patients with alcohol dependence, consecutively admitted to four addiction treatment facilities in Warsaw, Poland participated in the study. Of the 154 eligible patients, 118 (76.6%) completed a standardized follow-up assessment at 12 months. Results: Previous suicide attempts were common in adults treated for alcohol dependence with 43% patients in the present sample reporting an attempt at some point during their lifetime. Additionally, more than 62% of those with a lifetime suicide attempt reported making an impulsive attempt. Lifetime suicide attempts were not associated with post-treatment relapse (chi-square = 2.37, d.f. = 1, p = 0.124). However, impulsive suicide attempts strongly predicted relapse (OR = 2.81, 95% CI = 1.13-6.95, p = 0.026) and time to relapse (OR = 2.10, 95% CI = 1.18-3.74, p = 0.012) even after adjusting for other measures of baseline psychopathology, depression, impulsivity, hopelessness and alcohol use severity.
Precontemplated and impulsive suicide attempts among individuals with alcohol dependence
Journal of studies on alcohol, 2006
Alcohol dependence confers risk for suicidal behavior. Some suicide attempts are precontemplated, whereas other attempts are impulsive. The purpose of this study was to compare characteristics and correlates of impulsive and precontemplated suicide attempts. Data were derived from analysis of The Collaborative Study on the Genetics of Alcoholism (COGA), which is a six-site family pedigree study of individuals in treatment for alcoholism (probands), relatives of probands, and control families. Subjects in the analysis were age 18 years or older with a diagnosis of current alcohol dependence according to the Diagnostic and Statistical Manual, Third Edition, Revised. Individuals reporting a lifetime history of one or more suicide attempts were divided into two strata: suicide attempters with a history of suicidal ideation that persisted for a week or more, conceptualized as attempters showing precontemplation (n=330), and suicide attempters without a history of persistent ideation, con...
Acta Psychiatrica Scandinavica, 1997
ACTA PSYCHIATRICA SCANDINAVICA ISSN 0001-69OX t th Suominen K, Isometsa E, Henriksson M, Ostamo A, Lonnqvist J. Hopelessness, impulsiveness and intent among suicide attempters with major depression, alcohol dependence, or both. Acta Psychiatr Scand 1997: 96: 142-149. 0 Munksgaard 1997. I
Iranian journal of psychiatry and behavioral sciences, 2011
Impulsivity appears to play an important role in suicidal behavior. The aim of this cross-sectional study was to compare the impulsivity, substance abuse, and family/friends history of suicide attempt between suicide-ideated and non suicide-ideated university students. The research population consisted of all the students of the University of Isfahan in the academic year of 2009-2010. Three hundred and forty students (136 boys and 204 girls) were selected randomly through cluster sampling, of whom 53 participants were suicide-ideated and the rest were non suicide-ideated. The instruments used in this study were the 11(th) version of Barratt Impulsivity Scale, Suicide Ideation Questionnaire, and the demographic questionnaire. Descriptive statistics and multivariate analysis of variance were used to examine hypothesis. There was a significant difference between suicide ideated and non-suicide ideated subjects in impulsivity (F=3.83, p< 0.001). Accordingly, significant differences w...
Journal of Affective Disorders, 2006
Background: Impulsivity is a personality trait thought to be linked to suicide. Yet, not all suicides are highly impulsive. We aimed to better understand clinical, behavioral and psychosocial correlates of the association between suicide and impulsive behavior. Methods: One hundred sixty four suicide cases with impulsivity scores based on the Barratt Impulsivity Scale (BIS) were investigated. To examine the most extreme phenotypes, one hundred suicide cases, representing subjects with BIS scores above the 70th percentile and below the 30th percentile, were compared on clinical, behavioral and psychosocial suicide risk factors assessed by way of structured psychological autopsy methods with best informants. Results: The impulsive suicide cases were significantly younger, exhibited higher measures of aggressive behavior, and were more likely to have a cluster B diagnosis as well as lifetime and 6-month prevalence of alcohol and drug abuse/dependence. They also differed significantly from their non-impulsive counterparts on all subscales of the TCI except for Harm Avoidance and Reward Dependence. Impulsive suicide completers were more likely to have had a history of childhood abuse and to have experienced a triggering life event up to a week preceding their death. A multivariate analysis indicated that 6-month prevalence of substance abuse/dependence and high aggressive behavior remained significant even after controlling for other significant variables. Limitations: This study was carried out using proxy-based interviews. Conclusions: Most of the known clinical and behavioral risk factors commonly associated with suicide are particularly valid for impulsive suicide completers. Further, triggering and adverse life events seem to play a role primarily in impulsive suicide.
Suicidal behaviors and drug abuse: impulsivity and its assessment
Drug and Alcohol Dependence, 2004
Impulsivity appears to play an important role in suicidal behaviors and drug abuse, which are two psychiatric problems that may interact with one another. Interpretation of the literature on impulsivity in these behaviors may be complicated by the variety of measurement techniques for the assessment of impulsivity. There are three general types of impulsivity assessment: self-report, biological, and laboratory behavioral. Because laboratory behavioral measures both meet an operational definition of impulsivity and are sensitive to state-dependent changes in impulsivity, this paper presents data that focuses on laboratory behavioral performance among samples emitting suicidal behaviors or substance abuse. To better account for influence of impulsivity in these psychiatric disturbances, no single source of measurement should be used without the consideration of other types of instruments.
Alcohol Dependence and Suicidal Behavior: From Research to Clinical Challenges
Harvard Review of Psychiatry, 2006
Epidemiological and clinical data suggest high rates of suicidal behavior in alcohol-dependent individuals. Suicide attempters are likely to be young, to be single or separated, and to have made prior attempts. They differ from non-attempters by higher levels of impulsive aggression, drug use, and psychiatric comorbidity, particularly personality and depressive disorders. Treatment-seeking, alcohol-dependent individuals often present with multiple risk factors. Early recognition of suicidal behavior is hindered, however, by insufficient data regarding the acute phenomenology of imminent risk. Similarly, little research is available to guide intervention efforts. Initial trials support the use of fluoxetine for the treatment of suicidal, alcohol-dependent persons with comorbid depressive disorders. Future studies may clarify the relative efficacy of various psychotherapeutic and pharmacological approaches to treating these patients.
Suicidal Behavior and Alcohol Abuse
International Journal of Environmental Research and Public Health, 2010
Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as
Predictors and Correlates of Suicide Attempts Over 5 Years in 1,237 Alcohol-Dependent Men and Women
American Journal of Psychiatry, 2003
Objective: In previous studies, factors related to a history of suicide attempts in persons with alcohol dependence have included sociodemographic variables, a more severe course of alcoholism, additional substance use disorders, and psychiatric comorbidity. This 5-year prospective study evaluated attributes associated with suicide attempts in a group of treatment-seeking persons with alcohol dependence. Psychiatric comorbidity was examined in terms of a distinction between substance-induced and independent psychiatric disorders.