Risk and protective factors for suicide mortality among patients with alcohol dependence

Galen Chin Lun Hung, Chia Tzu Cheng, Jia Rong Jhong, Shang Ying Tsai, Chiao Chicy Chen, Chian Jue Kuo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population. Method: We enrolled patients with alcohol dependence (ICD-9 code 303) consecutively admitted to a psychiatric center in northern Taiwan from January 1, 1985, through December 31, 2008 (N = 2,793). Using patient linkage to the national mortality database (1985-2008), we determined that 960 patients died during the study period. Of those deaths, 65 patients died of suicide. On the basis of risk-set sampling for the selection of controls, we conducted a nested case-control study and collected the information by means of a standardized chart review process. We estimated the standardized mortality ratio (SMR) for suicide mortality. Conditional logistic regression was employed for exploring the risk and protective factors for suicide. Results: The study subjects had excessive suicide and all-cause deaths, with SMRs of 21.2 and 12.7, respectively. We pinpointed auditory hallucination (adjusted risk ratio [aRR] = 1.80, P = .04) and attempted suicide (aRR = 7.52, P = .001) as the risk factors associated with suicide. In contrast, protective factors included financial independence (aRR = 0.11, P = .005) and being married (aRR = 0.16, P = .02). Intriguingly, those with physical illnesses had a lower risk of suicide (aRR = 0.15, P = .01). Conclusions: Compared with the general population, those with alcohol dependence faced excessive suicide mortality. For a comprehensive approach to suicide prevention, recognizing and improving the protective factors could have equal importance in mitigating the risk of suicide.

Original languageEnglish
Pages (from-to)1687-1693
Number of pages7
JournalJournal of Clinical Psychiatry
Volume76
Issue number12
DOIs
Publication statusPublished - Dec 1 2015

Fingerprint

Suicide
Alcoholism
Mortality
Odds Ratio
International Classification of Diseases
Protective Factors
Attempted Suicide
Hallucinations
Taiwan
Population
Psychiatry
Case-Control Studies
Cause of Death
Logistic Models
Databases

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Risk and protective factors for suicide mortality among patients with alcohol dependence. / Hung, Galen Chin Lun; Cheng, Chia Tzu; Jhong, Jia Rong; Tsai, Shang Ying; Chen, Chiao Chicy; Kuo, Chian Jue.

In: Journal of Clinical Psychiatry, Vol. 76, No. 12, 01.12.2015, p. 1687-1693.

Research output: Contribution to journalArticle

Hung, Galen Chin Lun ; Cheng, Chia Tzu ; Jhong, Jia Rong ; Tsai, Shang Ying ; Chen, Chiao Chicy ; Kuo, Chian Jue. / Risk and protective factors for suicide mortality among patients with alcohol dependence. In: Journal of Clinical Psychiatry. 2015 ; Vol. 76, No. 12. pp. 1687-1693.
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abstract = "Objective: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population. Method: We enrolled patients with alcohol dependence (ICD-9 code 303) consecutively admitted to a psychiatric center in northern Taiwan from January 1, 1985, through December 31, 2008 (N = 2,793). Using patient linkage to the national mortality database (1985-2008), we determined that 960 patients died during the study period. Of those deaths, 65 patients died of suicide. On the basis of risk-set sampling for the selection of controls, we conducted a nested case-control study and collected the information by means of a standardized chart review process. We estimated the standardized mortality ratio (SMR) for suicide mortality. Conditional logistic regression was employed for exploring the risk and protective factors for suicide. Results: The study subjects had excessive suicide and all-cause deaths, with SMRs of 21.2 and 12.7, respectively. We pinpointed auditory hallucination (adjusted risk ratio [aRR] = 1.80, P = .04) and attempted suicide (aRR = 7.52, P = .001) as the risk factors associated with suicide. In contrast, protective factors included financial independence (aRR = 0.11, P = .005) and being married (aRR = 0.16, P = .02). Intriguingly, those with physical illnesses had a lower risk of suicide (aRR = 0.15, P = .01). Conclusions: Compared with the general population, those with alcohol dependence faced excessive suicide mortality. For a comprehensive approach to suicide prevention, recognizing and improving the protective factors could have equal importance in mitigating the risk of suicide.",
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AU - Kuo, Chian Jue

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N2 - Objective: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population. Method: We enrolled patients with alcohol dependence (ICD-9 code 303) consecutively admitted to a psychiatric center in northern Taiwan from January 1, 1985, through December 31, 2008 (N = 2,793). Using patient linkage to the national mortality database (1985-2008), we determined that 960 patients died during the study period. Of those deaths, 65 patients died of suicide. On the basis of risk-set sampling for the selection of controls, we conducted a nested case-control study and collected the information by means of a standardized chart review process. We estimated the standardized mortality ratio (SMR) for suicide mortality. Conditional logistic regression was employed for exploring the risk and protective factors for suicide. Results: The study subjects had excessive suicide and all-cause deaths, with SMRs of 21.2 and 12.7, respectively. We pinpointed auditory hallucination (adjusted risk ratio [aRR] = 1.80, P = .04) and attempted suicide (aRR = 7.52, P = .001) as the risk factors associated with suicide. In contrast, protective factors included financial independence (aRR = 0.11, P = .005) and being married (aRR = 0.16, P = .02). Intriguingly, those with physical illnesses had a lower risk of suicide (aRR = 0.15, P = .01). Conclusions: Compared with the general population, those with alcohol dependence faced excessive suicide mortality. For a comprehensive approach to suicide prevention, recognizing and improving the protective factors could have equal importance in mitigating the risk of suicide.

AB - Objective: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population. Method: We enrolled patients with alcohol dependence (ICD-9 code 303) consecutively admitted to a psychiatric center in northern Taiwan from January 1, 1985, through December 31, 2008 (N = 2,793). Using patient linkage to the national mortality database (1985-2008), we determined that 960 patients died during the study period. Of those deaths, 65 patients died of suicide. On the basis of risk-set sampling for the selection of controls, we conducted a nested case-control study and collected the information by means of a standardized chart review process. We estimated the standardized mortality ratio (SMR) for suicide mortality. Conditional logistic regression was employed for exploring the risk and protective factors for suicide. Results: The study subjects had excessive suicide and all-cause deaths, with SMRs of 21.2 and 12.7, respectively. We pinpointed auditory hallucination (adjusted risk ratio [aRR] = 1.80, P = .04) and attempted suicide (aRR = 7.52, P = .001) as the risk factors associated with suicide. In contrast, protective factors included financial independence (aRR = 0.11, P = .005) and being married (aRR = 0.16, P = .02). Intriguingly, those with physical illnesses had a lower risk of suicide (aRR = 0.15, P = .01). Conclusions: Compared with the general population, those with alcohol dependence faced excessive suicide mortality. For a comprehensive approach to suicide prevention, recognizing and improving the protective factors could have equal importance in mitigating the risk of suicide.

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