Co-ingested alcohol and the timing of deliberate self-poisonings

Objective: Investigating diurnal variation in the timing of suicidal behaviours offers opportunity to better understand its various proximal risk factors. Acute use of alcohol is a potent proximal risk factor for suicidal behaviour, though the nature of this risk is poorly understood. The aim of this study was to compare the diurnal variation in time of poison ingestion between deliberate self-poisonings that involve alcohol versus those that do not. Methods: A retrospective analysis of consecutive presentations to a toxicology service following deliberate self-poisoning, 1996–2016. An independent samples Kolmogorov–Smirnov test was performed to test the null hypothesis that the diurnal distribution of poison ingestion time was equal across self-poisonings that did and did not involve alcohol co-ingestion. Presence of circadian rhythmicity was established using cosinor analysis. Results: A total of 11,088 deliberate self-poisoning records, for 7467 patients (60.8% females), were included in the analysis. In all, 31.3% of the total records involved alcohol co-ingestion. Distribution of exposure time was significantly different between deliberate self-poisonings that did and did not involve alcohol ( p < 0.001). The alcohol co-ingestion group showed a significantly greater prominent peak with poisoning occurring later in the evening (~20:00 hours) compared to poisonings that did not involve alcohol (~18:00 hours). Conclusion: This study exposed the differential diurnal patterns in deliberate self-poisoning according to the presence of alcohol co-ingestion. This analysis adds to the accumulating evidence that suicidal behaviour that involves alcohol co-ingestion represents a distinct subtype, which may be driven by alcohol consumption patterns in society. This also means that this large proportion of deliberate self-poisonings may not otherwise have occurred if it were not for alcohol consumption, underscoring the importance of drug and alcohol services for alcohol-related self-harm.

Alcohol Abuse and Suicide Attempt in Iran: A Case-Crossover Study

<p>Alcohol use and its disorders are associated with increased risk of suicidal behaviors Research has shown that 6-8% of those who use alcohol have a history of suicide attempt. Given the prohibition of alcohol use legally, the increased alcohol consumption, and the lack of strong evidence in favor of its use associated with suicide in Iran, this study was conducted to determine the link between suicide attempt and alcohol abuse. The case-crossover method was used in this research. Out of 305 referrals to the emergency room due to a suicide attempt, 100 reported drinking alcohol up to six hours before their attempt. Paired Matching and Usual Frequency were employed to analyze the data with STATA 12.0. The probability of attempting suicide up to six hours after drinking alcohol appeared increased by 27 times (95% CI: 8.1-60.4). Separate analysis for each of these hours from the first to the sixth hour after alcohol use was also performed. Fifty percent of attempted suicides happened one hour after alcohol use. Relative risk for the first and second hour was 10% and 5% respectively. Alcohol use is a strong proximal risk factor for attempted suicide among Iranian subjects. Prevention of alcohol use should be considered in setting up of the national Suicide attempt prevention program.<strong></strong></p>