Aims There has been a marked increase in suicide fatalities among college-age students in recent years. Moreover, heavy alcohol use, a well-known risk factor for suicide, is present on most campuses. Yet, no prospective studies have examined alcohol use patterns among college students as predictors of suicidal behaviors. Methods Online of 40,335 students at four universities took place at the beginning of four academic years, 2015–2018. Of these, 2296 met criteria for an increased risk of suicidal behavior and completed 1- and/or 6-month follow-up evaluation(s). Baseline assessments included the Alcohol Use Disorders Identification Test to quantify alcohol consumption and resulting problems, and measures of depression, suicidal ideation and suicidal behavior. Results Suicide attempts during follow-up were reported by 35 (1.5%) of high-risk students. Regression analyses indicated that baseline severity of alcohol use consequences, but not amount of alcohol consumption, was associated with greater odds of a follow-up suicide attempt after controlling for baseline suicidal ideation, functional impairment and history of suicide attempts. Conclusions Among college students at elevated risk for suicide, the severity of alcohol-related consequences was a significant predictor of future suicide attempts. Alcohol consumption was not a significant predictor, suggesting that the amount students drink is less of a concern for suicidal behavior than are the problems (e.g. failing to meet expectations, experiencing blackouts) associated with drinking.

中文翻译：

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自杀和饮酒是大学生未来自杀行为的预测因素

目标 近年来，大学生自杀死亡人数显着增加。此外，大量饮酒是众所周知的自杀危险因素，在大多数校园中都存在。然而，还没有前瞻性研究检验大学生的饮酒模式作为自杀行为的预测因素。方法 2015-2018 年四个学年之初，四所大学的 40,335 名学生参与了在线调查。其中，2296 人符合自杀行为风险增加的标准，并完成了 1 个月和/或 6 个月的随访评估。基线评估包括酒精使用障碍识别测试，以量化饮酒量和由此产生的问题，以及抑郁症、自杀意念和自杀行为的测量。结果 35 名（1.5%）高危学生在随访期间报告了自杀企图。回归分析表明，在控制基线自杀意念、功能障碍和自杀企图历史后，饮酒后果的基线严重程度（而非饮酒量）与后续自杀企图的更大几率相关。结论 在自杀风险较高的大学生中，酒精相关后果的严重程度是未来自杀企图的重要预测因素。饮酒量并不是一个重要的预测因素，这表明学生的饮酒量对自杀行为的影响较小，而对与饮酒相关的问题（例如未能达到期望、经历昏厥）的影响较小。