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Alcohol Dependence and Suicide-Related Ideation/Behaviors in an Israeli Household Sample, With and Without Major Depression

Authors

  • Gal Shoval,

    1. Geha Mental Health Center, Petah Tiqva, Israel
    2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Dvora Shmulewitz,

    1. New York State Psychiatric Institute, New York, New York
    2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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  • Melanie M. Wall,

    1. New York State Psychiatric Institute, New York, New York
    2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
    3. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
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  • Efrat Aharonovich,

    1. New York State Psychiatric Institute, New York, New York
    2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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  • Baruch Spivak,

    1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Beer-Yaakov Ness-Ziona Mental Health Center, Ness Ziona, Israel
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  • Avraham Weizman,

    1. Geha Mental Health Center, Petah Tiqva, Israel
    2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    3. Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Deborah Hasin

    Corresponding author
    1. New York State Psychiatric Institute, New York, New York
    2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
    3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
    • Reprint requests: Deborah S. Hasin, PhD, Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive #123, New York, NY 10032; Tel.: 212-543-5035; Fax: 212-543-5913; E-mail: dsh2@columbia.edu

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Abstract

Background

Suicide-related ideation and behaviors (SRIB) are associated with both alcohol disorders and major depressive disorder (MDD). The objective of this study was to evaluate the relationship of alcohol dependence (AD) and major depression to the risk for lifetime SRIB.

Methods

Data from a community-based sample of 1,237 adult Israeli lifetime drinkers assessed with reliable diagnostic measures were analyzed using logistic regression.

Results

Lifetime SRIB was reported in 4.7% and was more prevalent among participants with AD (9.0%) than among those without AD (4.1%); p-value = 0.01. Although both AD and major depression were associated with SRIB (AD: OR 2.2, 95% CI 1.1 to 4.4; MDD: OR 11.4, 95% CI = 6.4 to 20.4), joint analysis showed that AD without MDD increased risk for SRIB as compared to those without AD or MDD (OR 3.1, 95% CI 1.1 to 9.1), but AD did not increase risk among those with MDD (OR 1.1, 95% CI 0.4 to 2.7). Among those with AD, the severity of subclinical depressive symptoms was associated with increased SRIB.

Conclusions

These findings show that AD increases risk for SRIB among individuals without a history of major depression. Suicidal tendencies may be undetected and underdiagnosed in this group because of the absence of major depression and therefore left untreated. These findings should be considered when adopting suicide prevention or treatment strategies for this high-risk subpopulation.

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