High Prevalence of Suicidal Behavior in Severe Alcohol Use Disorder Linked to Specific Neurocognitive Deficits: The Cognition, Alcohol, Genes, and Environment Study.

OBJECTIVE

Alcohol Use Disorder (AUD) and Suicidal Thoughts and Behaviors (STB) frequently co-occur. Their association could be explained by a causal pathway and/or a shared liability related to mechanisms involved in aberrant decision-making. These pathways of risk remain to be tested and characterized.

METHODS

We introduce here the Cognition, Alcohol, Genes, and Environment (CAGE) study, a data collection project aiming to combine neurocognitive (cognitive and affective processes related to decision-making) and genetic data to study mechanisms contributing to the comorbidity of AUD and STB in persons recruited for a lifetime history of severe AUD. In this report, we conducted an interim analysis with the first 1,267 participants (68% females) to explore their alcohol use and the associations among AUD, STB, and neurocognitive mechanisms using correlation and regression analyses.

RESULTS

The average alcohol consumption in the sample was high (Alcohol Use Disorder Identification Test [AUDIT] total score = 9.55 [SD = 8.16]), though some participants reported alcohol abstinence (N = 230). The prevalence of STB-related items was elevated relative to previously published population-based estimates, from ~65% reporting thoughts of death to ~24% reporting a prior suicide attempt. We investigated the roles of neurocognitive variables and found that alcohol problems (AUDIT-P) were associated with inhibition and delay discounting, while the co-occurrence of AUD and suicide attempt was related to inhibition and shifting abilities.

CONCLUSIONS

These preliminary findings open research avenues to study the mechanisms related to the co-occurrence of AUD and STB, with the hope of reducing STB risk in this population.