Objective:

The authors examined the association between alcohol use disorder (AUD) and risk of suicide, before and after accounting for psychiatric comorbidity, and assessed the extent to which the observed association is due to a potentially causal mechanism or genetic and familial environmental confounding factors that increase risk for both.

Methods:

Longitudinal population-wide Swedish medical, criminal, and pharmacy registries were used to evaluate the risk of death by suicide as a function of AUD history. Analyses employed prospective cohort and co-relative designs, including data on 2,229,880 native Swedes born between 1950 and 1970 and observed from age 15 until 2012.

Results:

The lifetime rate of suicide during the observation period was 3.54% for women and 3.94% for men with AUD, compared with 0.29% and 0.76% of women and men, respectively, without AUD. In adjusted analyses, AUD remained robustly associated with suicide: hazard ratios across observation periods ranged from 2.61 to 128.0 among women and from 2.44 to 28.0 among men. Co-relative analyses indicated that familial confounding accounted for some, but not all, of the observed association. A substantial and potentially causal relationship remained after accounting for a history of other psychiatric diagnoses.

Conclusions:

AUD is a potent risk factor for suicide, with a substantial association persisting after accounting for confounding factors. These findings underscore the impact of AUD on suicide risk, even in the context of other mental illness, and implicate the time frame shortly after a medical or criminal AUD registration as critical for efforts to reduce alcohol-related suicide.

中文翻译：

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瑞典基于人群的队列中的酒精使用障碍和自杀风险。

客观的：

作者在考虑精神疾病之前和之后检查了酒精使用障碍 (AUD) 与自杀风险之间的关联，并评估了观察到的关联在多大程度上是由于潜在的因果机制或遗传和家庭环境混杂因素导致的双方的风险。

方法：

纵向全瑞典人口医疗、刑事和药学登记用于评估自杀死亡风险与 AUD 病史的关系。分析采用了前瞻性队列和相关设计，包括 2,229,880 名出生于 1950 年至 1970 年间并从 15 岁到 2012 年观察到的瑞典本土人的数据。

结果：

在观察期间，有 AUD 的女性和男性的终生自杀率分别为 3.54% 和 3.94%，而没有 AUD 的女性和男性分别为 0.29% 和 0.76%。在调整后的分析中，AUD 仍然与自杀密切相关：整个观察期间的风险比在女性中为 2.61 至 128.0，在男性中为 2.44 至 28.0。相关分析表明，家族混杂因素占观察到的关联的一部分，但不是全部。在考虑了其他精神病诊断的历史后，仍然存在实质性和潜在的因果关系。

结论：

澳元是自杀的一个潜在危险因素，在考虑了混杂因素后，这种关联仍然存在。这些发现强调了 AUD 对自杀风险的影响，即使在其他精神疾病的情况下也是如此，并暗示在 AUD 医疗或刑事登记后不久的时间框架对于减少酒精相关自杀的努力至关重要。