Abstract
Background
Individuals who die from suicide commonly have consumed alcohol immediately beforehand, often in large quantities. However, prospective cohort data on regular alcohol use as a risk factor for suicide are lacking.
Method
As part of the Health Professionals Follow-up Study, 47,654 men free of cancer prospectively reported their drinking habits, including average use, drinking frequency, and typical maximal use on repeated occasions beginning in 1986. Participants were followed for death to 2002.
Results
A total of 136 men died from suicide during follow-up. Quantity of alcohol consumed per drinking day tended to be associated with a greater risk of suicide mortality, with an adjusted hazard ratio among men consuming 30.0 or more grams (more than two drinks) per drinking day of 2.42 (95% confidence interval, 0.75–7.80; P-trend 0.05). Average alcohol consumption, drinking frequency, and binge drinking were not independently associated with risk. The apparent relationship of quantity consumed per drinking day with risk was not substantially changed by adjustment for serious illness or other dietary factors and was most notable for suicide associated with firearm use.
Conclusions
Among men, risk of death from suicide tends to be associated primarily with quantity of alcohol consumed per drinking day, not with drinking frequency or overall alcohol consumption. This finding supports guidelines that limit consumption among men who choose to drink alcohol to two drinks or less per drinking day.
Similar content being viewed by others
References
Borges G, Cherpitel CJ, MacDonald S, Giesbrecht N, Stockwell T, Wilcox HC (2004) A case-crossover study of acute alcohol use and suicide attempt. J Stud Alcohol 65:708–714
May PA, Van Winkle NW, Williams MB, McFeeley PJ, DeBruyn LM, Serna P (2002) Alcohol and suicide death among American Indians of New Mexico: 1980–1998. Suicide Life Threat Behav 32:240–255
Castle K, Duberstein PR, Meldrum S, Conner KR, Conwell Y (2004) Risk factors for suicide in blacks and whites: an analysis of data from the 1993 National Mortality Followback Survey. Am J Psychiatry 161:452–458
Nemtsov A (2003) Suicides and alcohol consumption in Russia, 1965–1999. Drug Alcohol Depend 71:161–168
Ramstedt M (2001) Alcohol and suicide in 14 European countries. Addiction 96 Suppl 1:S59–S75
Kendall RE (1983) Alcohol and suicide. Subst Alcohol Actions Misuse 4:121–127
Murphy GE, Wetzel RD (1990) The lifetime risk of suicide in alcoholism. Arch Gen Psychiatry 47:383–392
Klatsky AL, Armstrong MA (1993) Alcohol use, other traits, and risk of unnatural death: a prospective study. Alcohol Clin Exp Res 17:1156–1162
Ross RK, Bernstein L, Trent L, Henderson BE, Paganini-Hill A (1990) A prospective study of risk factors for traumatic deaths in a retirement community. Prev Med 19:323–334
Tolstrup JS, Jensen MK, Tjonneland A, Overvad K, Gronbaek M (2004) Drinking pattern and mortality in middle-aged men and women. Addiction 99:323–330
U. S. Department of Agriculture, Agricultural Research Service (1999) Nutrient Data Laboratory. USDA nutrient database for standard reference, release 13. In, Beltsville, MD
Feskanich D, Rimm EB, Giovannucci EL, Colditz GA, Stampfer MJ, Litin LB, Willett WC (1993) Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc 93:790–796
Giovannucci E, Colditz G, Stampfer MJ, Rimm EB, Litin L, Sampson L, Willett WC (1991) The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 133:810–817
Mukamal KJ, Conigrave KM, Mittleman MA, Camargo CA Jr, Stampfer MJ, Willett WC, Rimm EB (2003) Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med 348:109–118
Eng PM, Rimm EB, Fitzmaurice G, Kawachi I (2002) Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men. Am J Epidemiol 155:700–709
Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1:466–473
Chasan-Taber S, Rimm EB, Stampfer MJ, Spiegelman D, Colditz GA, Giovannucci E, Ascherio A, Willett WC (1996) Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiology 7:81–86
Rich-Edwards JW, Corsano KA, Stampfer MJ (1994) Test of the National Death Index and Equifax Nationwide Death Search. Am J Epidemiol 140:1016–1019
Fisher LD, Lin DY (1999) Time-dependent covariates in the Cox proportional-hazards regression model. Annu Rev Public Health 20:145–157
Mukamal KJ, Ascherio A, Mittleman MA, Conigrave KM, Camargo CA Jr, Kawachi I, Stampfer MJ, Willett WC, Rimm EB (2005) Alcohol and risk for ischemic stroke in men: the role of drinking patterns and usual beverage. Ann Intern Med 142:11–19
Fernandez JR, Etzel C, Beasley TM, Shete S, Amos CI, Allison DB (2002) Improving the power of sib pair quantitative trait loci detection by phenotype winsorization. Hum Hered 53:59–67
Peet M (2003) Eicosapentaenoic acid in the treatment of schizophrenia and depression: rationale and preliminary double-blind clinical trial results. Prostaglandins Leukot Essent Fatty Acids 69:477–485
Kawachi I, Willett WC, Colditz GA, Stampfer MJ, Speizer FE (1996) A prospective study of coffee drinking and suicide in women. Arch Intern Med 156:521–525
Crombie IK, Pounder DJ, Dick PH (1998) Who takes alcohol prior to suicide? J Clin Forensic Med 5:65–68
Tanskanen A, Tuomilehto J, Viinamaki H, Vartiainen E, Lehtonen J, Puska P (2000) Joint heavy use of alcohol, cigarettes and coffee and the risk of suicide. Addiction 95:1699–1704
Conner KR, Li Y, Meldrum S, Duberstein PR, Conwell Y (2003) The role of drinking in suicidal ideation: analyses of Project MATCH data. J Stud Alcohol 64:402–408
Conigrave KM, Hu BF, Camargo CA Jr, Stampfer MJ, Willett WC, Rimm EB (2001) A prospective study of drinking patterns in relation to risk of type 2 diabetes among men. Diabetes 50:2390–2395
Gunzerath L, Faden V, Zakhari S, Warren K (2004) National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. Alcohol Clin Exp Res 28:829–847
Dinh-Zarr T, Goss C, Heitman E, Roberts I, DiGuiseppi C (2004) Interventions for preventing injuries in problem drinkers. Cochrane Database Syst Rev:CD001857
Suominen KH, Isometsa ET, Henriksson MM, Ostamo AI, Lonnqvist JK (1999) Treatment received by alcohol-dependent suicide attempters. Acta Psychiatr Scand 99:214–219
Sullivan LE, Fiellin DA, O’Connor PG (2005) The prevalence and impact of alcohol problems in major depression: a systematic review. Am J Med 118:330–341
Healy D, Whitaker C (2003) Antidepressants and suicide: risk-benefit conundrums. J Psychiatry Neurosci 28:331–337
Lapierre YD (2003) Suicidality with selective serotonin reuptake inhibitors: Valid claim? J Psychiatry Neurosci 28:340–347
Finn PR, Justus A, Mazas C, Steinmetz JE (1999) Working memory, executive processes and the effects of alcohol on Go/No-Go learning: testing a model of behavioral regulation and impulsivity. Psychopharmacology (Berl) 146:465–472
Fulwiler C, Eckstine J, Kalsy S (2005) Impulsive-aggressive traits, serotonin function, and alcohol-enhanced aggression. J Clin Pharmacol 45:94–100
Miller M, Hemenway D (1999) The relationship between firearms and suicide: a review of the literature. Aggression Violent Behav 4:59–75
Kaslow N, Thompson M, Meadows L, Chance S, Puett R, Hollins L, Jessee S, Kellermann A (2000) Risk factors for suicide attempts among African American women. Depress Anxiety 12:13–20
Alexander RE (2001) Stress-related suicide by dentists and other health care workers. Fact or folklore? J Am Dent Assoc 132:786–794
Murphy GE, Wetzel RD, Robins E, McEvoy L (1992) Multiple risk factors predict suicide in alcoholism. Arch Gen Psychiatry 49:459–463
Iribarren C, Sidney S, Jacobs DR Jr, Weisner C (2000) Hospitalization for suicide attempt and completed suicide: epidemiological features in a managed care population. Soc Psychiatry Psychiatr Epidemiol 35:288–296
Moyer LA, Boyle CA, Pollock DA (1989) Validity of death certificates for injury-related causes of death. Am J Epidemiol 130:1024–1032
Shaper AG (1995) The “unhealthy abstainers” question is still important. Addiction 90:488–490; discussion 493–488
Sobell LC, Brown J, Leo GI, Sobell MB (1996) The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug Alcohol Depend 42:49–54
Russell M, Peirce RS, Vana JE, Nochajski TH, Carosella AM, Muti P, Freudenheim J, Trevisan M (1998) Relations among alcohol consumption measures derived from the Cognitive Lifetime Drinking History. Drug Alcohol Rev 17:377–387
Stranges S, Wu T, Dorn JM, Freudenheim JL, Muti P, Farinaro E, Russell M, Nochajski TH, Trevisan M (2004) Relationship of alcohol drinking pattern to risk of hypertension: a population-based study. Hypertension 44:813–819
Bray BC, Almirall D, Zimmerman RS, Lynam D, Murphy SA (2006) Assessing the Total Effect of Time-Varying Predictors in Prevention Research. Prev Sci
Berglund M, Ojehagen A (1998) The influence of alcohol drinking and alcohol use disorders on psychiatric disorders and suicidal behavior. Alcohol Clin Exp Res 22:333S–345S
Acknowledgements
This study was supported by grants AA014900, AA11181, HL35464, HL03533, and CA55075 from the National Institutes of Health, Bethesda, MD. The funding sources for this work had no role in the analysis, presentation, or publication of results.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mukamal, K.J., Kawachi, I., Miller, M. et al. Drinking frequency and quantity and risk of suicide among men. Soc Psychiat Epidemiol 42, 153–160 (2007). https://doi.org/10.1007/s00127-006-0144-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-006-0144-1