Interpersonal stressors, substance abuse, and suicide.

In contrast to suicide in depression, suicide associated with alcoholism and substance dependence may be preceded more often by interpersonal loss and conflict 6 weeks prior to death. We used psychological autopsy methodology in an effort to clarify and extend these findings using a more comprehensive typology of interpersonal stressors. Subjects included 57 suicide victims with diagnoses of alcohol/substance dependence (A/SD; N = 30) and mood/anxiety disorders (M/AD; N = 27). Consistent with previous studies, a substantial majority of the A/SD suicide victims were confronted with interpersonal stressors in the 6 weeks prior to death. Our investigation extends previous findings by indicating that a) A/SD suicide victims are confronted with a broader range of interpersonal stressors than M/AD suicide completers and b) the types of interpersonal stressors experienced by A/SD subjects in the weeks prior to suicide involve conflicts/arguments and attachment disruptions.