CNS Drugs

, Volume 18, Issue 7, pp 423–436 | Cite as

Suicide in Alcohol-Dependent Individuals

Epidemiology and Management
  • Sami P. Pirkola
  • Kirsi Suominen
  • Erkki T. Isometsä
Therapy in Practice


The association of alcohol dependence with suicidal behaviour is well established although complex. On the basis of epidemiological and clinical evidence, alcohol dependence is known to increase the risk for suicidal ideation, suicide attempts and completed suicide. However, this risk is modulated by a wide variety of factors including sociodemographic, clinical, treatment-related and life situa-tional characteristics as well as current drinking status and the effect of inebriation. Treatment and management of patients with alcohol dependence and concomitant suicidal communication or suicide attempts is crucial, as is the recognition of these patients in emergency and other healthcare service contacts. The treatment strategies cannot be based on evidence derived from randomised clinical trials as such data do not exist. They must rather be based on current knowledge of risk factors for suicidal behaviour, efficacy of treatment for alcohol dependence or relevant co-morbid conditions and problems known to be common in treatment settings. In this article, we review the essential literature on the epidemiological and clinical research in the areas of alcohol dependence and suicidal behaviour. On the basis of current data and clinical experience, we suggest the following principles be followed in the management of alcohol-dependent individuals: (i) suicidal threats or communication by alcohol-dependent individuals in emergency and other contacts should be taken seriously; (ii) other mental disorders should be well evaluated, a consequent treatment plan initiated and follow-up arranged; (iii) appropriate and up-to-date pharmacological treatment should focus on both reducing the amount of drinking and treating symptoms of other mental disorders; (iv) psychotherapeutic efforts should be focused on emerging symptoms of both alcohol use and other mental disorders; and (v) known epidemiological and clinical risk factors, adverse life events in particular, should be recognised and taken into account


Suicidal Ideation Suicide Attempt Alcohol Dependence Suicidal Behaviour Personality Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this review.


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Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  • Sami P. Pirkola
    • 1
    • 2
  • Kirsi Suominen
    • 1
    • 3
  • Erkki T. Isometsä
    • 1
  1. 1.Department of Mental Health and Alcohol ResearchNational Public Health InstituteHelsinkiFinland
  2. 2.Development Centre for Welfare and HealthHealth and Social Services Division, STAKES National ResearchHelsinkiFinland
  3. 3.Department of PsychiatryJorvi Hospital, Helsinki University Central HospitalEspooFinland

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