- AUD-related hospitalization associated with 263% increased suicide hazard (HR 3.63, 95% CI 2.81-4.69, p<0.001).
- Elevated suicide risk concentrated in 30-44 year olds, men, unemployed and retirees (respective HRs 1.25; 2.17; 1.55; 1.39).
- AUD is a modifiable condition and a critical, urgent national suicide prevention target in Brazil.
Braz J Psychiatry. 2026 Nov 6. doi: 10.47626/1516-4446-2026-5056. Online ahead of print.
ABSTRACT
OBJECTIVE: Alcohol use disorder (AUD) is an established suicide risk factor, but evidence from low and middle-income countries (LMICs) is scarce. In Brazil, suicide has risen over the past two decades, especially in young adults, and alcohol consumption is among the highest in the Americas. The contribution of AUD to suicide risk in Brazil remains unclear.
METHODS: We used the 100 Million Brazilian Cohort linking nationwide sociodemographic, hospitalization, and mortality records (2008-2018). The analytic sample comprised 2,718,856 individuals. Multilevel Cox proportional hazards models estimated the association between time-varying AUD-related hospitalization and subsequent suicide, adjusting for municipal hospital availability and time-varying mood disorder hospitalizations.
RESULTS: Hospitalization for alcohol use was associated with a 263% increase in the hazard of suicide (HR 3.63, 95% CI 2.81-4.69, p<0.001). Elevated risk was also observed among persons aged 30-44 years (HR 1.25, 95% CI 1.11-1.40, p<0.001), men (HR 2.17, 95% CI 1.95-2.40, p<0.001), the unemployed (HR 1.55, 95% CI 1.40-1.71, p<0.001), and retirees (HR 1.39, 95% CI 1.08-1.79, p=0.010).
CONCLUSIONS: In this national cohort, AUD-related hospitalization strongly predicted suicide. As a modifiable condition, AUD is a critical target for suicide prevention in Brazil. Findings underscore urgent national prevention needs.
PMID:42993861 | DOI:10.47626/1516-4446-2026-5056
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