Identifying alcohol problems among suicide attempters visiting the emergency department

Abstract

BackgroundMany suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-related biochemical markers and Alcohol Use Disorder Identification Test Consumption (AUDIT-C) in suicide attempters who visited our ED based on the gold standard for clinical diagnosis used by psychiatrists for alcohol use disorder. Moreover, we aimed to search for a significant standard when clinicians make correct predictions about alcohol use disorder using these markers.MethodsAmong the subjects who visited ED following a suicide attempt, a total of 203 subjects were selected. Following a psychiatric interview, the subjects who met the criteria for alcohol abuse or alcohol dependence according to DSM-IV-TR in the past year were defined as the “alcohol use disorder” group. Although some subjects did not meet these criteria, men with a weekly alcohol intake of ≥14 drinks and women with a weekly alcohol intake of ≥7 drinks were classified as the “risky drinking” group. AUDIT-C was used as a self-report; further, aspartate aminotransferase, gamma-glutamyltransferase (GGT), and carbohydrate-deficient transferrin (CDT) were assayed using standard methods, and GGT–CDT was calculated using this formula: 0.8 × ln(GGT) + 1.3 × ln(%CDT).ResultsIn total, 88 subjects met the criteria for alcohol use disorder and 115 were included in the reference group. In the screening for alcohol use disorder, the AUC of AUDIT-C was 0.89 for men and 0.87 for women. In the screening for risky drinking, the AUC of AUDIT-C was 0.99 for men and 0.93 for women. Compared with other biochemical markers, AUDIT-C showed the highest AUC value for screening for both alcohol use disorder and risky drinking, with the trend being more prominent in men.ConclusionsAmong the biochemical markers, AUDIT-C yielded the highest sensitivity, specificity, and accuracy in diagnosing alcohol use disorder among suicide attempters in ED. Comparison of results revealed that the use of AUDIT-C with biochemical markers or its use alone can help screen for alcohol use disorder or risky drinking in clinical settings.

Factors Influencing Suicidal Ideation in Korean Youth: A Secondary Data Study Using Longitudinal Data from the Korean Youth Panel Survey

“…In this study, negative counseling experiences, frequent drinking, and current health status were all risk factors for suicidal ideation; these results are aligned with the evidence from numerous studies on the effects of mental health issues, history of mental illness, and alcohol consumption on suicidal ideation ( 15 – 17 ). Our results also corroborate those which showed that poor physical health is associated with poor mental health, and that people with a poor self-rated health status are more prone to suicidal ideation than those with a good self-rated health status ( 7 ).…”