IntroductionAlcohol use disorder (AUD) is among the strongest correlates of suicide death, but it is unclear whether AUD status is differentially associated with risk of suicide by particular methods.MethodsThe authors used competing risks models to evaluate the association between AUD status and risk of suicide by poisoning, suffocation, drowning, firearm, instruments, jumping, or other means in a large Swedish cohort born 1932–1995 (total N = 6,581,827; 48.8% female). Data were derived from Swedish national registers, including the Cause of Death Register and a range of medical registers.ResultsAfter adjusting for sociodemographic factors and familial liability to suicidal behavior, AUD was positively associated with risk of suicide for each method evaluated (cumulative incidence differences: 0.006–1.040 for females, 0.046–0.680 for males), except the association with firearm suicide in females. AUD was most strongly associated with risk of suicide by poisoning. Sex differences in the effects of AUD and family liability were observed for some, but not all, methods. Furthermore, high familial liability for suicidal behavior exacerbated AUD's impact on risk for suicide by poisoning (both sexes) and suffocation and jumping (males only), while the inverse interaction was observed for firearm suicide (males only).ConclusionsAUD increases risk of suicide by all methods examined and is particularly potent with respect to risk of suicide by poisoning. Differences in risk related to sex and familial liability to suicidal behavior underscore AUD's nuanced role in suicide risk. Future research should investigate targeted means restriction effectiveness among persons with AUD.

中文翻译：

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全国队列中的酒精使用障碍和特定自杀方式死亡的风险

简介酒精使用障碍 (AUD) 是与自杀死亡最密切的相关性之一，但尚不清楚通过特定方法，AUD 状态是否与自杀风险存在差异相关。方法作者使用竞争风险模型来评估 AUD 状态与自杀风险之间的关联在 1932 年至 1995 年出生的一大群瑞典人中，通过中毒、窒息、溺水、枪支、器械、跳跃或其他方式（总计氮= 6,581,827； 48.8% 女性）。数据来自瑞典国家登记册，包括死因登记册和一系列医疗登记册。结果在调整社会人口因素和自杀行为的家庭责任后，AUD 与每种评估方法的自杀风险呈正相关（累积发生率差异：女性为 0.006–1.040，男性为 0.046–0.680），但与女性持枪自杀相关的除外。 AUD 与中毒自杀风险的相关性最强。在某些（但不是全部）方法中观察到 AUD 和家庭责任影响的性别差异。此外，自杀行为的高家庭责任加剧了 AUD 对中毒（男女）、窒息和跳楼（仅限男性）自杀风险的影响，而持枪自杀（仅限男性）则观察到了相反的相互作用。 结论 AUD 通过以下方式增加自杀风险：所有方法均经过检验，对于降低中毒自杀风险尤其有效。与自杀行为的性别和家庭责任相关的风险差异强调了 AUD 在自杀风险中的微妙作用。未来的研究应该调查 AUD 患者有针对性的手段限制的有效性。