Adolescents who drink alcohol while sad or depressed have an increased risk of attempting suicide, whether or not they have previously had suicidal thoughts, a study indicates.

This underscores the need to screen adolescents for problematic alcohol use, as drinking while down may be an important marker for impulsive suicidal acts, the researchers report in the Journal of Adolescent Health.

Among almost 32,000 U.S. students screened for signs of suicide in grades 7 to 12, “drinking while down was associated with a 68 percent increase in (suicide) risk among adolescents who reported suicidal ideation,” Dr. Elizabeth A. Schilling told Reuters Health.

Among adolescents not reporting prior suicidal thoughts, “drinking while down was associated with a 3-fold increase in risk,” said Schilling, at the University of Connecticut Health Center in East Hartford.

Schilling’s group looked at alcohol use and self-reported suicide attempts using students’ responses to a suicide risk screening program from the 2001-2002 school year.

The students, 48 percent male, and 71 percent white, were mostly in grades 9 through 12 at the time of their screening and most were 14-17 years old.

During the year before their suicide screening, 12.2 percent of the students reported drinking while down and of these, nearly 18 percent reported suicide attempts. By contrast only about 3 percent of those who did not drink while down reported a suicide attempt.

“Drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year,” the investigators found.

Suicide prevention is challenging when youths do not show suicidal ideas before attempting suicide, Schilling and colleagues point out, so screening young people to see if they tend to drink alcohol while depressed may provide “an alternative avenue for identification and early intervention.”

SOURCE: Journal of Adolescent Health, April 2009.