果冻影院

The study, published in BJPsych Open, did not identify a clear association with levels of alcohol consumption and risk of suicide attempt or self-harm, other than among those with 鈥榩robable dependence鈥� (the highest consumption level); rather, they identified signs of alcohol negatively impacting people鈥檚 lives as risk factors.

Lead author, PhD candidate Sarah Ledden (果冻影院 Psychiatry), said: 鈥淲e found that it鈥檚 not just how much people drink that is associated with their risk of suicide or self-harm, but whether they show signs of more problematic alcohol use. Drinking alcohol might not be the problem per se, but how it鈥檚 affecting your life and potentially causing you problems.鈥�

The study involved 14,949 people, broadly representative of the general public in England, who completed surveys (Adult Psychiatric Morbidity Surveys) about alcohol consumption and patterns of harmful use (measured by the Alcohol Use Disorder Identification Test 鈥� AUDIT). The researchers compared this to self-reported incidence of suicide attempts, suicidal thoughts and non-suicidal self-harm in the past year (their study did not include mortality data to measure suicide deaths).

The study team found that whether other people have expressed concern about someone鈥檚 drinking was the strongest predictor of suicide attempt, suicidal thoughts,听and self-harm risk. People whose friends, family or colleagues have expressed concerns about their drinking were found to be three times as likely than those who hadn鈥檛 received any concern from others to have attempted suicide in the last year, two and a half times as likely to have had suicidal thoughts, and one and a half times as likely to have self-harmed (after accounting for confounding factors such as self-reported mental health problems, past year drug use, deprivation, age and others).

People with dependence symptoms 鈥� such as an inability to stop drinking, failure to meet normal expectations due to drinking, and feeling a need to drink after a heavy session 鈥� and those who reported harmful effects of drinking 鈥� such as drink-related guilt, memory loss, or injury 鈥� also faced higher odds of suicide attempt or self-harm.

There was no clear pattern based on levels of consumption, as there were not consistent differences in suicide attempt and self-harm risk between people with light, moderate, and hazardous drinking consumption. However, those in the highest category of consumption (鈥榩robable dependence鈥�, counted as drinking more than 30 units of alcohol per week) did face higher odds of suicide attempt and self-harm.

The researchers say that as the research was cross-sectional (one snapshot in time, rather than longitudinal), they cannot say whether harmful drinking is what makes mental health worse, or rather if it is a sign of already declining mental health 鈥� but they say the causation may go in both directions.

Sarah Ledden added: 鈥淚n our study, we found that alcohol misuse, particularly if it impairs someone鈥檚 day-to-day functioning, may be a modifiable risk factor for suicide and self-harm, so helping people with alcohol dependence may help to prevent suicides.

鈥淧eople should be aware that if they are concerned about someone鈥檚 drinking patterns, it could well be a sign that person鈥檚 mental health is very poor and they might be at risk of harming themselves.鈥�

Senior author Dr Alexandra Pitman (果冻影院 Psychiatry and Camden & Islington NHS Foundation Trust) said: 鈥淥ur findings suggest that clinicians should inquire particularly carefully about suicidal behaviour in anyone with signs of harmful drinking, using non-judgemental and sensitive questioning, as this provides an important opportunity for therapeutic assessment and risk management.

鈥�Gaining an understanding of the circumstances that lead to binge drinking and dependence whilst using a motivational interviewing approach may help identify how harmful drinking patterns might be shifted to the benefit of the patient, thereby reducing risk.鈥�

Dr Emily Finch, Chair of the Addictions Faculty at the Royal College of Psychiatrists, said: 鈥淭his research shows a clear link between alcohol use, self-harm and suicidality, indicating a person鈥檚 pattern of drinking has the most impact rather than frequency or quantity alone. This suggests we could reduce the risk of suicidality in people who use alcohol by examining their relationship with bingeing, concern from friends and family, and dependence symptoms.

鈥淧eople who use alcohol often receive very different crisis care than those who don鈥檛, and it is vital that they are not excluded from therapeutic interventions to tackle self-harm. We must urgently incorporate harm minimisation and alcohol treatment into crisis care and safety planning, to ensure those struggling with alcohol use are not forgotten about.鈥�

The study was funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research.

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