ALCOHOL AND SUICIDAL-BEHAVIOR

Elucidating the role of alcohol in the suicidal process appears important, since the mortality rate from suicide is increased among alcoholics and the incidence of alcoholism high among suicide attempters. Suicide and attempted suicide in alcoholics are often precipitated by actual or threatened separation. The presence of early separation from parental objects and alcohol abuse in the parental home constitute a risk factor for suicidal behaviour. Relatively protracted depressions often occur in suicidal alcoholics. Various depression scales along with clinical interviews should be used to facilitate the diagnosis. Repeated assessments are recommendend. The treatment of alcoholism and depression, and the reduction of alcohol consumption seem to be an effective instrument of suicide prevention. The treatment should be easily available and include the application of psychopharmacologic and psychologic treatment, adjusted to suicidal alcoholics' inability to think in abstract terms. Psychodynamic knowledge should be used to learn how to handle the patient's poor self-esteem, to encourage them to undergo treatment, and to recognize care personnel's negative reactions. Continuous dialogue on these matters should be maintained at all clinics working with suicidal alcoholics.