Characteristics of completed suicide in different blood alcohol concentrations in Korea

Aims: This study aimed to determine the role of acute alcohol use among suicide decedents based on their blood alcohol concentrations (BAC), and identify sociodemographic and clinical characteristics associated with the differences in BAC.

Methods: Data were collected from nationwide autopsies conducted between May 2015 and November 2015 in South Korea. A total of 683 suicide decedents were classified into three groups according to the BAC at the time of autopsy: no alcohol (NA) group (BAC<0.01%), no intoxication (NI) group (0.01≤BAC<0.08%), and intoxication (I) group (BAC≥0.08%). Sociodemographic data and clinical factors related to suicide among the three groups were analyzed using a multinomial logistic regression analysis.

Results: Among the suicide decedents (N=683), the NA group was 55.6% (N=380), NI group was 15.7% (N=107), and I group was 28.7% (N=196). History of suicide attempts (odds ratio [OR]: 1.798, 95% confidence interval [CI]: 1.073-3.012) and absence of medical illness (OR: 1.633, CI: 1.038-2.571) were higher in the I group compared to the NA group. Psychiatric and medical illness triggers of suicide were significantly lower in the I group than the NA group (OR: 0.325, CI: 0.118-0.892). Being male (OR: 2.494, CI: 1.363-4.565) and financial problems as triggers of suicide (OR: 3.234, CI: 1.636-6.393) were higher in the NI group than in the NA group. Being male and having financial problems were associated with no intoxication (0.01≤BAC<0.08%), whereas the history of suicide attempts and absence of medical and/or psychiatric illness were associated with acute alcohol intoxication (BAC≥0.08%) in the suicide decedents.

Conclusions: Suicide decedents had different characteristics based on different BACs identified in the autopsy. The differences in acute alcohol intoxication and no intoxication in suicide decedents may have implications for the targeted prevention of suicides related to alcohol.