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Soc Psychiatry Psychiatr Epidemiol (2011) 46:11271132 DOI 10.1007/s00127-010-0287-y
ORIGINAL PAPER
The effect of risky alcohol use and smoking on suicide risk: ndings from the German MONICA/KORA-Augsburg Cohort Study
Barbara Schneider Jens Baumert Andrea Schneider Birgitt Marten-Mittag
Christa Meisinger Natalia Erazo Gal P. Hammer Karl-Heinz Ladwig
Received: 17 July 2010 / Accepted: 3 September 2010 / Published online: 21 September 2010 Springer-Verlag 2010
AbstractBackground Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplied effect on risk prediction has not been investigated so far.
Methods In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 2574 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption.
B. Schneider (&)
Department of Psychiatry, Psychosomatic Medicineand Psychotherapy, Johann Wolfgang Goethe-University of Frankfurt/Main, Heinrich-Hoffmann-Strae 10, 60528 Frankfurt/Main, Germanye-mail: [email protected]
J. Baumert A. Schneider C. Meisinger K.-H. Ladwig
Institute of Epidemiology, Helmholtz Zentrum Mnchen, German Research Center for Environmental Health (GmbH), Neuherberg, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany
B. Marten-Mittag N. Erazo K.-H. Ladwig
Department of Psychosomatic Medicine, Medical Psychology and Psychotherapy, Klinikum rechts der Isar,Technical University of Mnchen, Ismaninger Strae 22, 81675 Mnchen, Germany
G. P. HammerInstitute for Medical Biostatistics, Epidemiology,and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Strae 69, 55131 Mainz, Germany
Results After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.144.37) and for smoking (SMR = 2.30; 95% CI 1.363.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.079.46) was observed for smokers with risky alcohol consumption. Conclusions The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness.
Keywords Smoking Alcohol Suicide Epidemiology
Introduction
Completed suicide has...