A Comparative Study of Suicidal Behaviour in Male Alcohol Dependent Individuals with and without Personality Disorder

Abstract

Background: Alcohol dependence and personality disorder are each independently linked to suicide risk, but their combined influence on suicidal behaviour remains poorly characterized. Objective: To compare the presence, pattern and severity of suicidal behaviour between male alcohol dependent individuals with and without personality disorder. Materials and Methods: A comparative cross-sectional study was done among consecutive male patients admitted in a deaddiction ward were screened; 50 with a confirmed personality disorder (cases) and 50 without (controls) were enrolled from 370 individuals screened. Alcohol dependence severity was assessed using the AUDIT and SADQ; personality disorder was diagnosed using the International Personality Disorder Examination (IPDE) and suicidal behaviour was assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS). Group comparisons used the chi-square test and the Mann-Whitney U test. Results: Suicidal behaviour was present in 58% of cases versus 16% of controls (χ²=18.9, p=0.001). Emotionally unstable personality disorder accounted for 72% of case-group diagnoses (borderline subtype 50%), and suicidal behaviour occurred in 72 % of the borderline subtype. Cases showed significantly more frequent multiple attempt methods (p=0.01), non-suicidal self injurious behaviour (p=0.04), preparatory acts (p=0.02), and family history of suicide (p=0.01), with numerically higher lethality, despite no significant difference in alcohol dependence severity between groups. Conclusion: Comorbid personality disorder, particularly the borderline and impulsive subtypes is associated with more frequent, lethal and premeditated suicidal behaviour in male alcohol dependent individuals. Systematic personality assessment alongside suicide risk screening is warranted in alcohol deaddiction settings.