The role of drinking in suicidal ideation: Analyses of project MATCH data

Objective: The associations of suicidal ideation with both the intensity (drinks per drinking day) and frequency of alcohol consumption were examined in a longitudinal study of treated alcoholics. Method: The data are from alcohol dependent subjects (1,187 men and 374 women) enrolled in Project MATCH, a multisite clinical trial of psychosocial treatments of alcoholism. Multivariate analyses for correlated data using generalized estimating equation approaches were performed to examine correlates of suicidal ideation at study entry and at 3-, 9and 15-month follow-up. Analyses were stratified by gender and controlled statistically for depression and alcoholism severity. Results: Suicidal ideation was common among women (15.5%) and men (9.9%) entering treatment, and at least 3.6% of women and 4.2% of men reported suicidal ideation at each follow-up. There were gender patterns in suicidal ideation. In women, intensity was associated with suicidal ideation, but even nonintense drinking became associated with suicidal ideation with more frequent drinking (intensity-frequency interaction). In men, intensity was also associated with suicidal ideation, whereas frequency was unrelated. Antisocial personality disorder in men but not in women, and depression in both groups, were also linked to suicidal ideation. Conclusions: Suicidal ideation is prevalent among treated alcoholics. Drinking is strongly associated with suicidal ideation and in women even light drinking, if it occurs regularly, is associated with suicidal ideation, with implications for suicide risk-recognition and intervention.