Case-control study in China of risk factors for suicide in men with alcohol use disorders

This secondary analysis of China's National Psychological Autopsy Study assesses the risk factors for suicide among men with alcohol use disorders (AUDs)--the second most common psychiatric diagnosis among suicide decedents in China.

Based on data collected from family members and close associates, the characteristics of 68 men with AUDs who died by suicide and 51 men with AUDs who died of other injuries at 23 geographically representative locations in China were compared using univariate and multivariate logistic regression models. Interactions between AUDs and other risk factors for suicide were explored using data from 448 male suicide decedents and 521 men who died from accidental injuries.

After adjusting for covariates, risk factors for suicide among men with AUDs were history of previous suicide attempts (odds ratio [OR] = 46.72, 95% CI [4.70, 464.89]), acute negative life events in the 2 days before death (OR = 18.92, 95% CI [3.32, 107.88]), and comorbid major depressive disorder (OR = 14.65, 95% CI [2.93, 73.31]). These three factors accounted for 54.3% of the variance in outcome. There was a statistically significant interaction between AUDs and major depression; the association between major depression and suicide risk was weaker in men with AUDs than in men without AUDs.

Among men with AUDs in China, prior suicidal behavior, acute life events, and major depression confer risk for suicide. However, the risk associated with depression in men with AUDs is somewhat less than the risk of suicide associated with depression in men without AUDs.