Alcohol Use Disorder Equally Linked to Suicide Across Genders, Study Finds

A new investigation uncovered compelling evidence challenging previous notions about the association between alcohol use disorder (AUD) and suicide mortality.

Contrary to earlier assumptions of sex-specific differences, the study reveals that individuals, regardless of gender, with AUD face similarly heightened odds of dying by suicide. Illuminating the critical intersection of substance use and mental health, these findings underscore the urgent need for comprehensive strategies to address AUD within suicide prevention efforts.

“Regardless of there not being a statistically significant difference between male and female individuals in the association between AUD and suicide mortality, it is clear that individuals with AUD have elevated odds of dying by suicide compared with those without an AUD,” the researchers wrote.

Image Credit: Pormezz - stock.adobe.com

AUD is a significant public health concern worldwide, not only due to its detrimental effects on physical health but also its association with mental health issues and risk of suicide. A recent systematic review and meta-analysis published in JAMA Network Open sought to investigate whether the link between AUD and suicide mortality differs between males and females.

The investigation analyzed data from 24 studies comprising a total of 37,870,699 participants, with approximately 60% being male and 40% female. Participants ranged from 15 years old to those aged 65 years or older. The systematic search encompassed various databases, including Embase, MEDLINE, PsycINFO, PubMed, and Web of Science, up to April 27, 2022.

One of the critical insights of this research was the revelation that previous reports of sex-specific associations between AUD and suicide may have been influenced by biases introduced by study design. The meta-regression analyses indicated that study design—whether longitudinal or cross-sectional—significantly impacted the observed association between AUD and suicide mortality for both male (log OR, 0.68; 95% CI, 0.08–1.28; P = .03) and female (log OR, 1.41; 95% CI, 0.57–2.24; P < .001) participants.

Among the longitudinal studies analyzed, both sexes with AUD demonstrated statistically significantly higher odds of dying by suicide compared with their counterparts without AUD. Specifically, the pooled odds ratios were 2.68 (95% CI, 1.86–3.87; I² = 99%) for males and 2.39 (95% CI, 1.50–3.81; I² = 90%) for females. Researchers noted these findings challenge previous notions that the association between AUD and suicide mortality might vary between genders.

“Regardless of there not being a statistically significant difference between male and female individuals in the association between AUD and suicide mortality, it is clear that individuals with AUD have elevated odds of dying by suicide compared with those without an AUD,” the researchers wrote. “Coupled with the finding that over 80% of individuals who die by suicide had contact with the health care system in the year prior to their suicide, there are clear implications for suicide prevention efforts within the health care system.”

Based on the results, the study acknowledged the importance of recognizing and addressing AUD as a critical component of suicide prevention strategies. Simple routine screening measures for AUD could play a vital role in identifying individuals at risk and providing timely interventions. The researchers noted the need for more nuanced approaches to understanding the complex interplay between substance use disorders and mental health outcomes.

“The temporal relationship that can be discerned from the meta-analyses of longitudinal studies speaks to the importance of a risk management approach among individuals with an AUD,” they continued. “However, suicide risk management is only possible if AUD is identified. Thus, it is imperative to screen for alcohol use among individuals presenting with depression and/or suicidal ideation.”

By revealing consistent associations across genders, the study advocates for more inclusive and comprehensive approaches to addressing AUD within suicide prevention strategies, potentially saving countless lives in the process.

Reference

Lange S, Kim KV, Lasserre AM, et al. Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(3):e241941. doi:10.1001/jamanetworkopen.2024.1941