The role of alcohol use disorder and alcohol consumption in suicide attempts--a secondary analysis of 1921 suicide attempts.

BACKGROUND: It is not known how characteristics of suicide attempts vary with different forms of alcohol involvement. The aim of this study is to clarify the role of alcohol use disorder and acute alcohol consumption in suicide attempts. METHODS: Data on 1921 suicide attempts was gathered in a major German city over a 5-year period. Suicide attempts were categorised according to a diagnosis of alcohol use disorder and acute alcohol consumption at the time of the attempt. Group comparisons and multinomial logistic regression were used for statistical analysis. RESULTS: In 331 suicide attempts (17%) an alcohol use disorder was diagnosed. Six hundred and twenty-two suicide attempts (32%) were committed with acute alcohol consumption. Suicide attempts by individuals with alcohol use disorder were more often committed by men, older individuals and as a recurrent attempt, independently of alcohol consumption at the time of the attempt. When alcohol was consumed in suicide attempts by individuals with alcohol use disorder, low-risk methods were used most often. CONCLUSIONS: Individuals with a diagnosis of alcohol use disorder are a high-risk group for multiple suicide attempts and should be a target group for suicide prevention. Screening for suicidality should be a regular part of the clinical assessment in individuals with alcohol use disorder.

[Optimised services for depressed patients. The German Alliance Against Depression]. / Optimierte Versorgung depressiv Erkrankter. Das Deutsche Bündnis gegen Depression.

Optimised treatment of depression is important to patients and their families and has important health economic implications in Germany. The optimised treatment of depression can best be achieved with multilevel interventions targeting different groups. The "German Alliance Against Depression" emerged within the framework of the "German Research Network on Depression and Suicidality". This action-oriented programme aims to improve the care of depressed patients through parallel interventions on four levels. These levels are as follows: 1) co-operation with general practitioners, 2) a public relations campaign, 3) training programmes for community facilitators and 4) interventions with high-risk groups. The programme was tested in Nuremberg. Results were promising with a 24% decrease in suicidal behaviour reported. In the meantime, groups in Germany and abroad declared their interest in adapting the programme. Today, close to 40 German regions have implemented similar multilevel interventions. The European Alliance Against Depression (EAAD) formed and now includes 17 countries. The EAAD was mentioned in the 2005 EU green paper on mental health as an "example for best practice". Improving the care of affected persons requires a systematic research approach. The "Mental Health Research Network" contributes to research related to the optimisation of services for persons with mental disorders.