Psychiatric co-morbidity, suicidal behaviour and suicidal ideation in alcoholics seeking treatment

Aims. To estimate the impact of co‐morbid disorbers for suicidal ideas in alcohol‐dependent subjects seeking treatment. Design. Life‐time psychiatric co‐morbidity and previous suicidal behaviours were assessed retrospectively after detoxification ( t 1). In addition, suicidal behaviours were assessed 12 months after discharge ( t 2) . Setting. An inpatient detoxification treatment unit. Participants. Two hundred and fifty dependent inpatients were studied after detoxification. One hundred and forty‐nine of them participated in the follow‐up face‐to‐face interview. Measurements. Using two extended standardized interviews (CIDI and IPDE) psychiatric co‐morbidity (DSM‐III‐R, Axes I and II) was assessed at t 1; suicide attempts were reported at t 1 and t 2, and suicidal ideas were assessed at t 2. Findings. A history of suicide attempts was reported by 29.2% at t 1, and suicidal ideas by 14.1% and suicide attempts by 5.4% at the follow‐up ( t 2). One female patient committed suicide within 6 months of discharge from hospital. The following co‐morbidity patterns were associated with the greatest risk for suicidal ideas. Anxiety and depressive disorders, Axes I and II disorders, and a history of suicide attempt (for suicidal ideas at ( t 2). Conclusions. Our results underline the importance of psychiatric co‐morbidity for the suicidal risk in alcohol‐dependent patients, while alcoholism itself appears to be only a moderate risk factor.