Hazardous drinking and clinical correlates among suicidal patients receiving psychiatric inpatient care at military medical settings

Addict Behav. 2020 Mar:102:106178. doi: 10.1016/j.addbeh.2019.106178. Epub 2019 Oct 23.

Abstract

Background: To describe prevalence and identify clinical correlates of hazardous drinking among suicidal inpatients at military medical settings.

Method: Data were drawn from the baseline assessment of a multisite randomized controlled trial of Post-Admission Cognitive Therapy (PACT). Participants were military Service members or adult beneficiaries (N = 218) who were admitted to inpatient care following a suicide-related crisis. Hazardous alcohol use in the past year was assessed using the Alcohol Use Disorder Identification Test (AUDIT).

Results: The average AUDIT score was 6.78 (SD = 7.87), with 28.9% reporting hazardous drinking (scored ≥8 on the AUDIT). Hazardous drinkers were more likely than nonhazardous drinkers to meet diagnosis of Substance Use Disorder (SUD; Odds Ratio [OR] = 5.96, 95% confidence intervals [CI] = 2.13, 16.71). Hazardous drinking was neither associated with measures of suicide ideation nor aborted or interrupted suicide attempt. However, hazardous drinkers had greater risk of having both single (RRR [Relative Risk Ratio] = 2.55, 95% CI = 1.18, 5.50) and multiple actual suicide attempts (RRR = 2.38, 95% CI = 1.06, 5.32) than nonhazardous drinkers. The association between hazardous drinking and single (but not multiple) actual suicide attempt remained significant after controlling for gender, depressive symptoms, hopelessness, Post-Traumatic Stress Disorder, and SUD (adjusted RRR = 2.48, 95% CI = 1.09, 5.65).

Conclusions: A history of actual suicide attempt is associated with hazardous alcohol use among suicidal psychiatric inpatients. Assessment of drinking and drug use may inform case conceptualization and treatment of suicide-related behaviors in psychiatric inpatient settings.

Keywords: Alcohol; Military; Psychiatric inpatient; Suicide attempt; Suicide ideation.

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / psychology
  • Alcohol-Related Disorders / epidemiology
  • Alcohol-Related Disorders / psychology*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology*
  • Dangerous Behavior*
  • Female
  • Hospitalization
  • Hospitals, Military
  • Humans
  • Major Depressive Disorder / epidemiology
  • Major Depressive Disorder / psychology*
  • Male
  • Military Personnel / psychology*
  • Military Personnel / statistics & numerical data
  • Psychiatric Department, Hospital
  • Stress Disorders, Post-Traumatic / psychology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data
  • Young Adult