Séverine Lannoy1, Henrik Ohlsson2, Jan Sundquist2,3,4, Kristina Sundquist2,3,4, Alexis C Edwards1. 1. Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. 2. Center for Primary Health Care Research, Lund University, Malmö, Sweden. 3. Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 4. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
INTRODUCTION: Alcohol use disorder (AUD) has been identified as a strong risk factor for suicide attempt. However, few studies have considered protective factors that may moderate this association, such as resilience. METHODS: We used longitudinal nationwide Swedish data of 903,333 males born 1960-1980 and 48,285 males born 1949-1951. We performed Cox proportional hazards models to test the role of AUD, resilience, and their interaction on risk for suicide attempt. We used co-relative models to account for familial factors. RESULTS: Alcohol use disorder was strongly associated with increased risk of suicide attempt [hazard ratio (HR) = 12.22], while resilience was associated with reduced risk (HR = 0.73). Multiplicative interaction (HR = 1.21) showed that, in the context of AUD, the protective role of resilience on risk of suicide attempt was somewhat attenuated. Co-relative analyses supported both familial liability and a possible causal pathway between AUD, resilience, and suicide attempt. In the cohort born 1949-1951, resilience subcomponents-social maturity, interests, psychological energy, home conditions, and emotional control-were all associated with reduced suicide attempt risk (HRs between 0.63 and 0.74). CONCLUSION: While resilience is associated with reduced risk of suicide attempt, this effect is less pronounced in the context of AUD. These associations are potentially causal.
INTRODUCTION: Alcohol use disorder (AUD) has been identified as a strong risk factor for suicide attempt. However, few studies have considered protective factors that may moderate this association, such as resilience. METHODS: We used longitudinal nationwide Swedish data of 903,333 males born 1960-1980 and 48,285 males born 1949-1951. We performed Cox proportional hazards models to test the role of AUD, resilience, and their interaction on risk for suicide attempt. We used co-relative models to account for familial factors. RESULTS: Alcohol use disorder was strongly associated with increased risk of suicide attempt [hazard ratio (HR) = 12.22], while resilience was associated with reduced risk (HR = 0.73). Multiplicative interaction (HR = 1.21) showed that, in the context of AUD, the protective role of resilience on risk of suicide attempt was somewhat attenuated. Co-relative analyses supported both familial liability and a possible causal pathway between AUD, resilience, and suicide attempt. In the cohort born 1949-1951, resilience subcomponents-social maturity, interests, psychological energy, home conditions, and emotional control-were all associated with reduced suicide attempt risk (HRs between 0.63 and 0.74). CONCLUSION: While resilience is associated with reduced risk of suicide attempt, this effect is less pronounced in the context of AUD. These associations are potentially causal.
Authors: Beatrice Kennedy; Ruoqing Chen; Fang Fang; Unnur Valdimarsdottir; Scott Montgomery; Henrik Larsson; Katja Fall Journal: J Epidemiol Community Health Date: 2019-02-04 Impact factor: 3.710
Authors: Matthew K Nock; Guilherme Borges; Evelyn J Bromet; Jordi Alonso; Matthias Angermeyer; Annette Beautrais; Ronny Bruffaerts; Wai Tat Chiu; Giovanni de Girolamo; Semyon Gluzman; Ron de Graaf; Oye Gureje; Josep Maria Haro; Yueqin Huang; Elie Karam; Ronald C Kessler; Jean Pierre Lepine; Daphna Levinson; Maria Elena Medina-Mora; Yutaka Ono; José Posada-Villa; David Williams Journal: Br J Psychiatry Date: 2008-02 Impact factor: 9.319