[Psychosocial features of suicide cases with alcohol problem: a psychological autopsy study]

Alcohol use disorder is a well-known risk factor for suicide, as alcohol problems can deteriorate the medical and psychosocial conditions of individuals. Furthermore, the pharmacological effect of alcohol can cause impulsive behavior in individuals. However, few studies have investigated the association of alcohol problems with suicide in Japan. The purpose of the present study was to investigate psychosocial and psychiatric features of suicide-completers with alcohol problems in last one year before their death.

Since December 2007, we have been conducting a Japan-wide study on suicide-completers using a psychological autopsy method, a semi-structured interview by a psychiatrist and a mental health professional including a public health nurse with the closest bereaved. Items questioned included family environment, suicide situation, history of life, labor situation, economic problems, and psychiatric diagnosis according to DSM-IV criteria at the time of death. As of December 2009, we had collected psychosocial and psychiatric information about 76 Japanese suicide cases.

16 suicide-completers with alcohol problems ("Alcohol problem" group 21.1%) were all males and almost middle-aged workers. The percentages of debt and accident proneness in "Alcohol problem" group were significantly higher than "Non-alcohol problem" group. In "Alcohol problem group", none of them have had treatment of alcohol dependence. The prevalence of alcohol use disorders in "Alcohol problem group" was significantly higher than in "Nonalcohol problem" group (81.2% vs. 0%).

The findings of the present study suggest that it is important to improvement of psychiatric care in alcohol dependence for prevention future suicides among alcoholics. Furthermore, enlightenment the association between alcohol problems and suicide to the public and medical doctors is required.