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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Addictive Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1396855

Clinical characteristics and 6-month follow-up of adults with and without alcohol use disorder who self-harm

Provisionally accepted
Petter Olsson Petter Olsson 1*Stefan Wiktorsson Stefan Wiktorsson 1Lotta M. Strömsten Lotta M. Strömsten 2Ellinor Salander Renberg Ellinor Salander Renberg 2Bo Runeson Bo Runeson 3Margda Waern Margda Waern 1
  • 1 Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Göteborg, Västergötland, Sweden
  • 2 Umeå University, Umeå, Västerbotten, Sweden
  • 3 Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden

The final, formatted version of the article will be published soon.

    Background: Alcohol use disorder (AUD) is associated with suicidal behavior, but prospective clinical studies are lacking. Aim: To compare clinical characteristics and 6-month outcomes in persons with and without AUD who self-harm. Methods: 804 adults (mean age 33, age range 18-95, 541 women and 263 men, 666 with suicide attempts and 138 with non-suicidal self-injuries at index) at three Swedish university hospitals took part in a research interview that included the Mini International Neuropsychiatric Interview (MINI). Subsequent non-fatal suicidal behavior within six months was identified by record review; suicides were identified by national register. Results: At index, 39% of the men and 29% of the women had AUD. Over two thirds of these cases (69%) were identified by the MINI, but not by clinical AUD diagnosis. While trait impulsivity was more common among persons with AUD than those without (56% vs 36%, Padj = <.001), impulsivity in connection with the index attempt was noted in half of the participants in each group (48% vs 52%, Padj = 1). Subsequent suicidal behavior (fatal/non-fatal) occurred in 67 persons with AUD (26%) and in 98 without AUD (18%), a 60% higher risk among persons with AUD (OR = 1.60, 95% [CI 1.13-2.28], P = .009). Four persons with AUD (2%) and six without (1%) died by suicide within 6 months. Conclusion: Almost a third of patients presenting at psychiatric emergency settings after self-harm fulfilled criteria for AUD, but clinicians often missed this diagnosis. Risk for subsequent suicidal behavior was elevated in patients with AUD. Educational interventions to improve recognition of alcohol use disorder may aid clinicians in the assessment and management of patients who present with self-harm.

    Keywords: Suicide, Alcohol use disoder, self-harm, Suicidal Behavior, suicide risk

    Received: 06 Mar 2024; Accepted: 22 Jul 2024.

    Copyright: © 2024 Olsson, Wiktorsson, Strömsten, Salander Renberg, Runeson and Waern. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Petter Olsson, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Göteborg, SE413 45, Västergötland, Sweden

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.