Alcohol Use Disorders and Suicidal Behaviour: A Narrative Review

Abstract

Background: Alcohol Use Disorders (AUD), affective disorders, and personality disorders are among the most prevalent mental health conditions observed in individuals exhibiting suicidal behavior, encompassing both completed and attempted suicides. A robust association between AUD and suicidal behavior has been established through retrospective and prospective cohort studies. Research on the relationship between alcohol consumption and self-harm has predominantly focused on Western and high-income countries, whereas approximately one-third of the global population, including half of the world's countries, lacks accessible suicide data. This study aims to present an updated review of empirical evidence regarding the risk of suicide associated with AUD in both developed and developing nations. 

Methods: We identified published meta-analyses, reviews, systematic reviews, randomized controlled trials, clinical studies, clinical trials, controlled clinical trials, observational studies, and case reports written in English and published between January 2004 and June 2024. Our search yielded a total of 312 papers. After reviewing titles and abstracts, 232 articles were excluded from the initial records. Following full-text review of the remaining 80 articles, a qualitative synthesis was conducted, highlighting the most representative 41 papers for inclusion in this overview. 

Results: Our analysis indicates that alcohol abuse is a significant risk factor for all forms of suicidal behavior. Alcohol consumption functions as both a predisposing and precipitating factor, contributing to maladaptive behaviors in both developing and developed countries. The clinical condition is exacerbated by alcohol use, which in turn increases the risk of suicide. 

Conclusions: Further research is essential to develop targeted psychological and pharmacological interventions aimed at preventing and treating these conditions, with the goal of reducing the risk of suicidal behavior associated with AUD. In developing countries, integrating public health and clinical strategies is crucial for effectively addressing suicide prevention.