Risk of suicidal behavior as a function of alcohol use disorder typologies : A Swedish population-based study
(2023) In Addiction- Abstract
Background and aims: Alcohol use disorder (AUD) is one of the strongest predictors of suicidal behavior. Here, we measured risk of suicide attempt and death as a function of AUD typologies. Design: We used AUD typologies from previous latent class analysis: (i) externalizing subtype (characterized by externalizing symptomatology and early age of onset; individuals in this group have lower education and higher familial/social difficulties); (ii) subtype described by minimal psychopathology; and (iii) internalizing subtype (characterized by internalizing symptomatology and later age of onset; individuals in this group have higher education). We used class membership to predict distal outcomes (attempt and death) and performed regressions... (More)
Background and aims: Alcohol use disorder (AUD) is one of the strongest predictors of suicidal behavior. Here, we measured risk of suicide attempt and death as a function of AUD typologies. Design: We used AUD typologies from previous latent class analysis: (i) externalizing subtype (characterized by externalizing symptomatology and early age of onset; individuals in this group have lower education and higher familial/social difficulties); (ii) subtype described by minimal psychopathology; and (iii) internalizing subtype (characterized by internalizing symptomatology and later age of onset; individuals in this group have higher education). We used class membership to predict distal outcomes (attempt and death) and performed regressions to evaluate whether differences in suicidal behavior were explained by the group characteristics (sex, age of onset, number and type of AUD registrations, familial/genetic risk for AUD, externalizing and internalizing behaviors, socio-economic indicators, marital status and childhood family status). We also evaluated the effect of suicide attempt prior to AUD. Setting and participants: Based on longitudinal Swedish registry data, we included 217 074 individuals with AUD born 1950–80. Measurements: Suicide attempts were identified using medical registers and deaths using the mortality register. Findings: Individuals with the externalizing subtype had higher risks of suicidal behavior than other groups [attempt: externalizing versus minimal psychopathology: odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.35, 1.35; externalizing versus internalizing: OR = 1.47, 95% CI = 1.46, 1.48; death: externalizing versus minimal psychopathology: OR = 1.57, 95% CI = 1.57, 1.58; externalizing versus internalizing: OR = 1.99, 95% CI = 1.93, 2.06]. Individuals with minimal psychopathology had higher risks than those with internalizing symptomatology (attempt: OR = 1.09, 95% CI = 1.08, 1.10, death: OR = 1.26, 95% CI = 1.23, 1.30). These differences were explained by age at registration and were related to the number of registrations, sex, education, family disruption and suicide attempt prior to AUD. Conclusions: Among people in Sweden, considering alcohol use disorder (AUD) heterogeneity appears to be a meaningful way to evaluate suicide risk. The highest risk of suicide attempt and death occurs in the externalizing subtype of AUD, followed by the minimal psychopathology subtype, and then the internalizing subtype.
(Less)
- author
- Lannoy, Séverine ; Ohlsson, Henrik LU ; Kendler, Kenneth S. ; Stephenson, Mallory ; Sundquist, Jan LU ; Sundquist, Kristina LU and Edwards, Alexis C.
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- in press
- subject
- keywords
- alcohol use disorder, externalizing behaviors, heterogeneity, internalizing behaviors, non-fatal suicide attempt, suicide death, typology
- in
- Addiction
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:37752713
- scopus:85172660919
- ISSN
- 0965-2140
- DOI
- 10.1111/add.16351
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
- id
- 563ac5fd-ca7b-4b37-a355-4713cea02aa2
- date added to LUP
- 2024-01-08 11:30:39
- date last changed
- 2024-04-23 07:08:08
@article{563ac5fd-ca7b-4b37-a355-4713cea02aa2,
abstract = {{<p>Background and aims: Alcohol use disorder (AUD) is one of the strongest predictors of suicidal behavior. Here, we measured risk of suicide attempt and death as a function of AUD typologies. Design: We used AUD typologies from previous latent class analysis: (i) externalizing subtype (characterized by externalizing symptomatology and early age of onset; individuals in this group have lower education and higher familial/social difficulties); (ii) subtype described by minimal psychopathology; and (iii) internalizing subtype (characterized by internalizing symptomatology and later age of onset; individuals in this group have higher education). We used class membership to predict distal outcomes (attempt and death) and performed regressions to evaluate whether differences in suicidal behavior were explained by the group characteristics (sex, age of onset, number and type of AUD registrations, familial/genetic risk for AUD, externalizing and internalizing behaviors, socio-economic indicators, marital status and childhood family status). We also evaluated the effect of suicide attempt prior to AUD. Setting and participants: Based on longitudinal Swedish registry data, we included 217 074 individuals with AUD born 1950–80. Measurements: Suicide attempts were identified using medical registers and deaths using the mortality register. Findings: Individuals with the externalizing subtype had higher risks of suicidal behavior than other groups [attempt: externalizing versus minimal psychopathology: odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.35, 1.35; externalizing versus internalizing: OR = 1.47, 95% CI = 1.46, 1.48; death: externalizing versus minimal psychopathology: OR = 1.57, 95% CI = 1.57, 1.58; externalizing versus internalizing: OR = 1.99, 95% CI = 1.93, 2.06]. Individuals with minimal psychopathology had higher risks than those with internalizing symptomatology (attempt: OR = 1.09, 95% CI = 1.08, 1.10, death: OR = 1.26, 95% CI = 1.23, 1.30). These differences were explained by age at registration and were related to the number of registrations, sex, education, family disruption and suicide attempt prior to AUD. Conclusions: Among people in Sweden, considering alcohol use disorder (AUD) heterogeneity appears to be a meaningful way to evaluate suicide risk. The highest risk of suicide attempt and death occurs in the externalizing subtype of AUD, followed by the minimal psychopathology subtype, and then the internalizing subtype.</p>}},
author = {{Lannoy, Séverine and Ohlsson, Henrik and Kendler, Kenneth S. and Stephenson, Mallory and Sundquist, Jan and Sundquist, Kristina and Edwards, Alexis C.}},
issn = {{0965-2140}},
keywords = {{alcohol use disorder; externalizing behaviors; heterogeneity; internalizing behaviors; non-fatal suicide attempt; suicide death; typology}},
language = {{eng}},
publisher = {{Wiley-Blackwell}},
series = {{Addiction}},
title = {{Risk of suicidal behavior as a function of alcohol use disorder typologies : A Swedish population-based study}},
url = {{http://dx.doi.org/10.1111/add.16351}},
doi = {{10.1111/add.16351}},
year = {{2023}},
}