Alcohol involvement in suicide and self-harm: Findings from two innovative surveillance systems.

BACKGROUND:
Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior.

AIMS:
This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations.

METHOD:
Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007-2013 were obtained from the National Self-Harm Registry Ireland.

RESULTS:
Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours.

LIMITATIONS:
Data was limited to routinely collected variables by the two different monitoring systems.

CONCLUSION:
Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.