Ledden Sarah, Moran Paul, Osborn David, Pitman Alexandra
Division of Psychiatry, University College London, UK.
Centre for Academic Mental Health, University of Bristol, UK; and National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
BJPsych Open. 2022 Nov 3;8(6):e192. doi: 10.1192/bjo.2022.594.
Alcohol use is a risk factor for suicidal behaviour, yet the nature of the relationship is unclear. Most research on the topic is conducted in clinical populations, with few studies exploring this association across the general population.
We investigated the association between specific domains of alcohol use and suicide attempt, suicidal thoughts and non-suicidal self-harm in a general population sample.
A total of 14 949 adults who completed the 2007 or 2014 Adult Psychiatric Morbidity Survey were included. We measured alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). Domains of alcohol use relating to risk categories, weekly consumption, binge drinking, dependence symptoms, harmful effects and concern from others were derived from relevant AUDIT items. Self-reported past year suicide attempt, suicidal thoughts and non-suicidal self-harm were measured with the Clinical Interview Schedule, Revised.
We found a linear association between total AUDIT score and outcomes. Three of six specific domains of alcohol use (dependence symptoms, harmful effects of drinking and binge drinking) were associated with increased odds of all three outcomes. There was no association of outcomes with the other domains of alcohol use.
We found evidence of a linear association between total AUDIT score and suicide attempt, suicidal thoughts and non-suicidal self-harm in a representative English general population sample. Our analyses suggest that where alcohol use significantly disrupts day-to-day functioning, this may underpin the relationship between alcohol use and suicide-related outcomes to a greater extent than higher alcohol consumption. Longitudinal research is needed to further understand these relationships.
饮酒是自杀行为的一个风险因素，但其关系的本质尚不清楚。关于该主题的大多数研究是在临床人群中进行的，很少有研究在普通人群中探讨这种关联。
我们在一个普通人群样本中调查了饮酒的特定领域与自杀未遂、自杀念头和非自杀性自伤之间的关联。
总共纳入了14949名完成2007年或2014年成人精神病发病率调查的成年人。我们使用酒精使用障碍识别测试（AUDIT）来测量饮酒情况。与风险类别、每周饮酒量、暴饮、依赖症状、有害影响和他人关注相关的饮酒领域是从相关的AUDIT项目中得出的。过去一年的自杀未遂、自杀念头和非自杀性自伤通过修订后的临床访谈时间表进行自我报告测量。
我们发现AUDIT总分与结果之间存在线性关联。饮酒的六个特定领域中的三个（依赖症状、饮酒的有害影响和暴饮）与所有三种结果的几率增加相关。结果与饮酒的其他领域没有关联。
我们在一个具有代表性的英国普通人群样本中发现了AUDIT总分与自杀未遂、自杀念头和非自杀性自伤之间存在线性关联的证据。我们的分析表明，饮酒严重扰乱日常功能的情况，可能比高饮酒量在更大程度上支撑了饮酒与自杀相关结果之间的关系。需要进行纵向研究以进一步了解这些关系。
