Alcohol and suicide.

It is well established that alcoholics have a very high suicide rate. The evidence is of two kinds: a) Follow up studies of alcoholics consistently reveal high suicide rates. The proportion dying by suicide varies from 8% (Kessel & Grossman, 1961) to 21% (Gabriel, 1935) depending on the length of follow up. These figures represent a risk 5080 times that of the general population. Most such studies were based on clinically identified populations of alcoholics and might not be representative of alcoholics in general. However: b) Retrospective studies of suicides consistently find that a high proportion (varying from 15% in southern England Barraclough et al., 1974 to 27% in Seattle Dorpat & Ripley, (1960) were alcoholics. The evidence of these retrospective studies is that suicide usually occurs at a late stage in the alcoholic career and is associated with things which are high risk factors for suicide in other settings e.g. divorce, a history of previous suicide attempts and increasing age. The origins of the close relationship between alcoholism and suicide have rarely been investigated, though the relationship is readily comprehended. Several elements probably contribute: 1. Alcohol dependence often leads to social decline-break up of marriage, loss of job and family ties-and the resulting social isolation is a potent cause of suicide. 2. Alcohol dependence leads to loss of self esteem and hence to depression and these psychological changes predispose to suicide. 3. Intoxication produces increased impulsiveness and a weakening of normal restraints against dangerous behavior.(ABSTRACT TRUNCATED AT 250 WORDS)