Impulsive suicide attempts predict post-treatment relapse in alcohol-dependent patients

Abstract

Background-The present study was designed to examine the influence of suicidality on relapse in alcohol-dependent patients. Specifically, a lifetime suicide attempt at baseline was used to predict relapse in the year after treatment. Also, the unique contribution of impulsive suicide attempts was examined.Methods-A total of 154 patients with alcohol dependence, consecutively admitted to four addiction treatment facilities in Warsaw, Poland participated in the study. Of the 154 eligible patients, 118 (76.6%) completed a standardized follow-up assessment at 12 months.Results-Previous suicide attempts were common in adults treated for alcohol dependence with 43% patients in the present sample reporting an attempt at some point during their lifetime. Additionally, more than 62% of those with a lifetime suicide attempt reported making an impulsive attempt. Lifetime suicide attempts were not associated with post-treatment relapse (chisquare=2.37, df=1, p=0.124). However, impulsive suicide attempts strongly predicted relapse (OR=2.81, 95%C.I. = 1.13-6.95, p=0.026) and time to relapse (OR=2.10, 95% C.I. = 1.18-3.74, p=0.012) even after adjusting for other measures of baseline psychopathology, depression, impulsivity, hopelessness and alcohol use severity.Conclusions-This study is the first to document the relationship between pre-treatment impulsive suicide attempts and higher likelihood of post-treatment relapse in alcohol-dependent patents. Clinicians should routinely conduct an assessment for previous suicide attempts in patients with alcohol use disorders, and when impulsive suicidality is reported, they should recognize the increased risk for relapse and formulate their patients' treatment plans accordingly with the goals of reducing both alcoholic relapse and suicide rates.

The CC genotype in HTR2A T102C polymorphism is associated with behavioral impulsivity in alcohol-dependent patients

“…As previously described in relation to suicidality (Wojnar et al, 2008), participants consisted of patients entering abstinence-based, drug-free alcohol treatment programs in residential treatment centers (270 patients) and outpatient clinics (34 patients) in Warsaw, Poland. Participation was confidential and voluntary; all patients were informed about the protocol of the study and gave written informed consent.…”

Physical Pain in Alcohol-Dependent Patients Entering Treatment in Poland—Prevalence and Correlates

“…The level of impulsivity was measured by the Barratt Impulsiveness Scale (BIS-11) (Patton et al, 1995), which is a subjective measure of impulsivity. A Polish version of BIS-11 was used, translated from the original version according to methodology described by Wojnar et al (2008). In this study, the BIS-11 total score was analyzed.…”

A meta-analysis of acute use of alcohol and the risk of suicide attempt

“…Notably, although correlated, AUA and AUD are distinct constructs (see (Conner et al, 2014)). For example studies have shown that AUA increases risk for suicidal behavior after adjusting for drinking pattern or AUD (Borges and Loera, 2010) and among those with a history of AUD, many instances of suicidal behavior occur outside windows of acute intoxication (Simon et al, 2002; Wojnar et al, 2008). Further, there are different proposed mechanisms underlying relations between AUA and AUD and suicidal behavior (Conner and Duberstein, 2004) (see also (Bagge and Sher, 2008) and (Conner et al, 2014) for a discussion).…”