{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:19:45Z","timestamp":1787804385725,"version":"build-2784847793"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AA027522"],"award-info":[{"award-number":["AA027522"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2024-02796"],"award-info":[{"award-number":["2024-02796"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Soc Psychiatry Psychiatr Epidemiol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are frequently comorbid and are individually associated with increased risk of suicidal behavior. However, whether their comorbidity exacerbates this risk has not been adequately investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using a Swedish birth cohort (born 1970\u20131990;\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009799,203\u2013858,983), we employed Aalen\u2019s linear hazards models to evaluate the risk of non-fatal suicide attempt (SA) as a function of registration for AUD and\/or PTSD. Models were stratified by sex and considered the temporal ordering of AUD and PTSD. We adjusted for registrations of major depression (MD) and other key covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall incidence of SA ranged from 16.52 to 19.29 per 10,000 person-years (PY). In models adjusted for MD and other covariates, PTSD accounted for an additional 12.19\u201322.09 SA cases per 10,000 PY; the corresponding range for AUD was 43.24\u201380.04, and the difference in effect size across predictors was more pronounced where AUD preceded PTSD. Comorbidity exacerbated risk: The interaction between PTSD and AUD accounted for 71.13-179.41 additional SA cases per 10,000 PY. In secondary models, interactions between AUD and MD conferred additional SA risk (40.50-127.88 additional SA cases per 10,000 PY), while interactions between PTSD and MD were very weak and, in most cases, negative (-13.26-3.29).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PTSD and AUD are independently associated with SA, but risk is substantially exacerbated among comorbid individuals. While the total effect of these conditions on SA risk is overall comparable across sexes, females whose PTSD precedes AUD are particularly burdened by comorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00127-026-03054-y","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T11:59:28Z","timestamp":1770379168000},"page":"1647-1659","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of alcohol use disorder and PTSD comorbidity on risk of suicide attempt"],"prefix":"10.1007","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4006-9710","authenticated-orcid":false,"given":"Alexis C.","family":"Edwards","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-7903","authenticated-orcid":false,"given":"Sara Larsson","family":"L\u00f6nn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-9943","authenticated-orcid":false,"given":"Ananda B.","family":"Amstadter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1498-4333","authenticated-orcid":false,"given":"Mallory","family":"Stephenson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7773-4553","authenticated-orcid":false,"given":"S\u00e9verine","family":"Lannoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2990-1166","authenticated-orcid":false,"given":"Casey","family":"Crump","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-5015","authenticated-orcid":false,"given":"Jan","family":"Sundquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8031-279X","authenticated-orcid":false,"given":"Kenneth S.","family":"Kendler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-6570","authenticated-orcid":false,"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"3054_CR1","unstructured":"Center for Disease Control and Prevention (2025) Suicide Data and Statistics. https:\/\/www.cdc.gov\/suicide\/facts\/data.html. Accessed 04\/16\/2025 2025"},{"key":"3054_CR2","unstructured":"World Health Organization (2025) Suicide. World Health Organization. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/suicide. Accessed 4\/16\/2025 2021"},{"key":"3054_CR3","unstructured":"Substance Abuse and Mental Health Services Administration (2023) Key substance use and mental health indicators in the united states: results from the 2022 National survey on drug use and health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration"},{"issue":"1","key":"3054_CR4","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.amepre.2024.03.002","volume":"67","author":"C Peterson","year":"2024","unstructured":"Peterson C, Haileyesus T, Stone DM (2024) Economic cost of U.S. suicide and nonfatal self-harm. Am J Prev Med 67(1):129\u2013133. https:\/\/doi.org\/10.1016\/j.amepre.2024.03.002","journal-title":"Am J Prev Med"},{"issue":"3","key":"3054_CR5","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1192\/bjp.181.3.193","volume":"181","author":"D Owens","year":"2002","unstructured":"Owens D, Horrocks J, House A (2002) Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 181(3):193\u2013199. https:\/\/doi.org\/10.1192\/bjp.181.3.193","journal-title":"Br J Psychiatry"},{"issue":"1","key":"3054_CR6","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-51762-9","volume":"14","author":"S Dhaubhadel","year":"2024","unstructured":"Dhaubhadel S, Ganguly K, Ribeiro RM, Cohn JD, Hyman JM, Hengartner NW, Kolade B, Singley A, Bhattacharya T, Finley P, Levin D, Thelen H, Cho K, Costa L, Ho YL, Justice AC, Pestian J, Santel D, Zamora-Resendiz R, Crivelli S, Tamang S, Martins S, Trafton J, Oslin DW, Beckham JC, Kimbrel NA, Million Veteran Program Suicide Exemplar Work G, McMahon BH (2024) High dimensional predictions of suicide risk in 4.2\u00a0million US veterans using ensemble transfer learning. Sci Rep 14(1):1793. https:\/\/doi.org\/10.1038\/s41598-024-51762-9","journal-title":"Sci Rep"},{"issue":"1","key":"3054_CR7","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02852-9","volume":"14","author":"A Pigoni","year":"2024","unstructured":"Pigoni A, Delvecchio G, Turtulici N, Madonna D, Pietrini P, Cecchetti L, Brambilla P (2024) Machine learning and the prediction of suicide in psychiatric populations: a systematic review. Transl Psychiatry 14(1):140. https:\/\/doi.org\/10.1038\/s41398-024-02852-9","journal-title":"Transl Psychiatry"},{"issue":"2","key":"3054_CR8","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1037\/bul0000084","volume":"143","author":"JC Franklin","year":"2017","unstructured":"Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, Musacchio KM, Jaroszewski AC, Chang BP, Nock MK (2017) Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull 143(2):187\u2013232. https:\/\/doi.org\/10.1037\/bul0000084","journal-title":"Psychol Bull"},{"issue":"3","key":"3054_CR9","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1056\/NEJMra1902944","volume":"382","author":"S Fazel","year":"2020","unstructured":"Fazel S, Runeson B (2020) Suicide. N Engl J Med 382(3):266\u2013274. https:\/\/doi.org\/10.1056\/NEJMra1902944","journal-title":"N Engl J Med"},{"issue":"3","key":"3054_CR10","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/j.drugalcdep.2013.04.016","volume":"132","author":"C Blanco","year":"2013","unstructured":"Blanco C, Xu Y, Brady K, P\u00e9rez-Fuentes G, Okuda M, Wang S (2013) Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: results from National epidemiological survey on alcohol and related conditions. Drug Alcohol Depend 132(3):630\u2013638","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"3054_CR11","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/cpsp.12006","volume":"19","author":"JL McCauley","year":"2012","unstructured":"McCauley JL, Killeen T, Gros DF, Brady KT, Back SE (2012) Posttraumatic stress disorder and co-occurring substance use disorders: advances in assessment and treatment. Clin Psychol Sci Pract 19(3):283","journal-title":"Clin Psychol Sci Pract"},{"issue":"2","key":"3054_CR12","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1037\/adb0000348","volume":"32","author":"SB Norman","year":"2018","unstructured":"Norman SB, Haller M, Hamblen JL, Southwick SM, Pietrzak RH (2018) The burden of co-occurring alcohol use disorder and PTSD in U.S. military veterans: comorbidities, functioning, and suicidality. Psychol Addict Behav 32(2):224\u2013229. https:\/\/doi.org\/10.1037\/adb0000348","journal-title":"Psychol Addict Behav"},{"issue":"7","key":"3054_CR13","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1176\/appi.ajp.2019.19070673","volume":"177","author":"AC Edwards","year":"2020","unstructured":"Edwards AC, Ohlsson H, Sundquist J, Sundquist K, Kendler KS (2020) Alcohol use disorder and risk of suicide in a Swedish population-based cohort. Am J Psychiatry 177(7):627\u2013634. https:\/\/doi.org\/10.1176\/appi.ajp.2019.19070673","journal-title":"Am J Psychiatry"},{"key":"3054_CR14","doi-asserted-by":"publisher","unstructured":"Conner KR, Hesselbrock VM, Meldrum SC, Schuckit MA, Bucholz KK, Gamble SA, Wines JD Jr., Kramer J (2007) Transitions to, and correlates of, suicidal ideation, plans, and unplanned and planned suicide attempts among 3,729 men and women with alcohol dependence. J Stud Alcohol Drugs 68(5):654\u2013662. https:\/\/doi.org\/10.15288\/jsad.2007.68.654","DOI":"10.15288\/jsad.2007.68.654"},{"key":"3054_CR15","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v40.1.02","author":"KR Conner","year":"2019","unstructured":"Conner KR, Bagge CL (2019) Suicidal Behavior: Links Between Alcohol Use Disorder and Acute Use of Alcohol. Alcohol Res Curr Rev. https:\/\/doi.org\/10.35946\/arcr.v40.1.02","journal-title":"Alcohol Res Curr Rev"},{"issue":"2","key":"3054_CR16","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1176\/appi.ajp.2016.16010077","volume":"174","author":"Y Barak-Corren","year":"2017","unstructured":"Barak-Corren Y, Castro VM, Javitt S, Hoffnagle AG, Dai Y, Perlis RH, Nock MK, Smoller JW, Reis BY (2017) Predicting suicidal behavior from longitudinal electronic health records. Am J Psychiatry 174(2):154\u2013162. https:\/\/doi.org\/10.1176\/appi.ajp.2016.16010077","journal-title":"Am J Psychiatry"},{"issue":"11","key":"3054_CR17","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-018-0965-0","volume":"20","author":"JL Gradus","year":"2018","unstructured":"Gradus JL (2018) Posttraumatic stress disorder and death from suicide. Curr Psychiatry Rep 20(11):98. https:\/\/doi.org\/10.1007\/s11920-018-0965-0","journal-title":"Curr Psychiatry Rep"},{"key":"3054_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.01998","volume":"11","author":"R Holliday","year":"2020","unstructured":"Holliday R, Borges LM, Stearns-Yoder KA, Hoffberg AS, Brenner LA, Monteith LL (2020) Posttraumatic stress disorder, suicidal ideation, and suicidal self-directed violence among U.S. military personnel and veterans: a systematic review of the literature from 2010 to 2018. Front Psychol 11:1998. https:\/\/doi.org\/10.3389\/fpsyg.2020.01998","journal-title":"Front Psychol"},{"key":"3054_CR19","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jad.2015.07.037","volume":"188","author":"JD Ribeiro","year":"2015","unstructured":"Ribeiro JD, Yen S, Joiner T, Siegler IC (2015) Capability for suicide interacts with states of heightened arousal to predict death by suicide beyond the effects of depression and hopelessness. J Affect Disord 188:53\u201359. https:\/\/doi.org\/10.1016\/j.jad.2015.07.037","journal-title":"J Affect Disord"},{"key":"3054_CR20","doi-asserted-by":"publisher","unstructured":"Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE Jr. (2010) The interpersonal theory of suicide. Psychol Rev 117(2):575\u2013600. https:\/\/doi.org\/10.1037\/a0018697","DOI":"10.1037\/a0018697"},{"issue":"2","key":"3054_CR21","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1521\/ijct.2015.8.2.114","volume":"8","author":"ED Klonsky","year":"2015","unstructured":"Klonsky ED, May AM (2015) The three-step theory (3ST): a new theory of suicide rooted in the ideation-to-action framework. Int J Cogn Ther 8(2):114\u2013129. https:\/\/doi.org\/10.1521\/ijct.2015.8.2.114","journal-title":"Int J Cogn Ther"},{"issue":"5","key":"3054_CR22","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1017\/S0033291716002841","volume":"47","author":"G Borges","year":"2017","unstructured":"Borges G, Bagge CL, Cherpitel CJ, Conner KR, Orozco R, Rossow I (2017) A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychol Med 47(5):949\u2013957. https:\/\/doi.org\/10.1017\/S0033291716002841","journal-title":"Psychol Med"},{"issue":"2","key":"3054_CR23","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1111\/add.12762","volume":"110","author":"N Giesbrecht","year":"2015","unstructured":"Giesbrecht N, Huguet N, Ogden L, Kaplan MS, McFarland BH, Caetano R, Conner KR, Nolte KB (2015) Acute alcohol use among suicide decedents in 14 US states: impacts of off-premise and on-premise alcohol outlet density. Addiction 110(2):300\u2013307. https:\/\/doi.org\/10.1111\/add.12762","journal-title":"Addiction"},{"issue":"3","key":"3054_CR24","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1080\/07481187.2020.1745954","volume":"46","author":"J Perez","year":"2022","unstructured":"Perez J, Beale E, Overholser J, Athey A, Stockmeier C (2022) Depression and alcohol use disorders as precursors to death by suicide. Death Stud 46(3):619\u2013627. https:\/\/doi.org\/10.1080\/07481187.2020.1745954","journal-title":"Death Stud"},{"issue":"6","key":"3054_CR25","doi-asserted-by":"publisher","first-page":"2380","DOI":"10.1017\/S0033291721004256","volume":"53","author":"AC Edwards","year":"2023","unstructured":"Edwards AC, Ohlsson H, Lannoy S, Stephenson M, Crump C, Sundquist J, Sundquist K, Kendler KS (2023) Shared genetic and environmental etiology between substance use disorders and suicidal behavior. Psychol Med 53(6):2380\u20132388. https:\/\/doi.org\/10.1017\/S0033291721004256","journal-title":"Psychol Med"},{"issue":"3","key":"3054_CR26","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.biopsych.2021.05.029","volume":"91","author":"N Mullins","year":"2022","unstructured":"Mullins N, Kang J, Campos AI, Coleman JRI, Edwards AC, Galfalvy H, Levey DF, Lori A, Shabalin A, Starnawska A, Su MH, Watson HJ, Adams M, Awasthi S, Gandal M, Hafferty JD, Hishimoto A, Kim M, Okazaki S, Otsuka I, Ripke S, Ware EB, Bergen AW, Berrettini WH, Bohus M, Brandt H, Chang X, Chen WJ, Chen HC, Crawford S, Crow S, DiBlasi E, Duriez P, Fernandez-Aranda F, Fichter MM, Gallinger S, Glatt SJ, Gorwood P, Guo Y, Hakonarson H, Halmi KA, Hwu HG, Jain S, Jamain S, Jimenez-Murcia S, Johnson C, Kaplan AS, Kaye WH, Keel PK, Kennedy JL, Klump KL, Li D, Liao SC, Lieb K, Lilenfeld L, Liu CM, Magistretti PJ, Marshall CR, Mitchell JE, Monson ET, Myers RM, Pinto D, Powers A, Ramoz N, Roepke S, Rozanov V, Scherer SW, Schmahl C, Sokolowski M, Strober M, Thornton LM, Treasure J, Tsuang MT, Witt SH, Woodside DB, Yilmaz Z, Zillich L, Adolfsson R, Agartz I, Air TM, Alda M, Alfredsson L, Andreassen OA, Anjorin A, Appadurai V, Soler Artigas M, der Van Auwera S, Azevedo MH, Bass N, Bau CHD, Baune BT, Bellivier F, Berger K, Biernacka JM, Bigdeli TB, Binder EB, Boehnke M, Boks MP, Bosch R, Braff DL, Bryant R, Budde M, Byrne EM, Cahn W, Casas M, Castelao E, Cervilla JA, Chaumette B, Cichon S, Corvin A, Craddock N, Craig D, Degenhardt F, Djurovic S, Edenberg HJ, Fanous AH, Foo JC, Forstner AJ, Frye M, Fullerton JM, Gatt JM, Gejman PV, Giegling I, Grabe HJ, Green MJ, Grevet EH, Grigoroiu-Serbanescu M, Gutierrez B, Guzman-Parra J, Hamilton SP, Hamshere ML, Hartmann A, Hauser J, Heilmann-Heimbach S, Hoffmann P, Ising M, Jones I, Jones LA, Jonsson L, Kahn RS, Kelsoe JR, Kendler KS, Kloiber S, Koenen KC, Kogevinas M, Konte B, Krebs MO, Landen M, Lawrence J, Leboyer M, Lee PH, Levinson DF, Liao C, Lissowska J, Lucae S, Mayoral F, McElroy SL, McGrath P, McGuffin P, McQuillin A, Medland SE, Mehta D, Melle I, Milaneschi Y, Mitchell PB, Molina E, Morken G, Mortensen PB, Muller-Myhsok B, Nievergelt C, Nimgaonkar V, Nothen MM, O\u2019Donovan MC, Ophoff RA, Owen MJ, Pato C, Pato MT, Penninx B, Pimm J, Pistis G, Potash JB, Power RA, Preisig M, Quested D, Ramos-Quiroga JA, Reif A, Ribases M, Richarte V, Rietschel M, Rivera M, Roberts A, Roberts G, Rouleau GA, Rovaris DL, Rujescu D, Sanchez-Mora C, Sanders AR, Schofield PR, Schulze TG, Scott LJ, Serretti A, Shi J, Shyn SI, Sirignano L, Sklar P, Smeland OB, Smoller JW, Sonuga-Barke EJS, Spalletta G, Strauss JS, Swiatkowska B, Trzaskowski M, Turecki G, Vilar-Ribo L, Vincent JB, Volzke H, Walters JTR, Shannon Weickert C, Weickert TW, Weissman MM, Williams LM, Wray NR, Zai CC, Ashley-Koch AE, Beckham JC, Hauser ER, Hauser MA, Kimbrel NA, Lindquist JH, McMahon B, Oslin DW, Qin X, Major Depressive Disorder Working Group of the Psychiatric Genomics C, Bipolar Disorder Working Group of the Psychiatric Genomics C, Eating Disorders Working Group of the Psychiatric Genomics C, German Borderline Genomics C, Workgroup MVPSE, Program VAMV, Agerbo E, Borglum AD, Breen G, Erlangsen A, Esko T, Gelernter J, Hougaard DM, Kessler RC, Kranzler HR, Li QS, Martin NG, McIntosh AM, Mors O, Nordentoft M, Olsen CM, Porteous D, Ursano RJ, Wasserman D, Werge T, Whiteman DC, Bulik CM, Coon H, Demontis D, Docherty AR, Kuo PH, Lewis CM, Mann JJ, Renteria ME, Smith DJ, Stahl EA, Stein MB, Streit F, Willour V, Ruderfer DM (2022) Dissecting the shared genetic architecture of suicide attempt, psychiatric disorders, and known risk factors. Biol Psychiatry 91(3):313\u2013327. https:\/\/doi.org\/10.1016\/j.biopsych.2021.05.029","journal-title":"Biol Psychiatry"},{"key":"3054_CR27","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jad.2022.04.006","volume":"308","author":"SM Blakey","year":"2022","unstructured":"Blakey SM, Griffin SC, Grove JL, Peter SC, Levi RD, Calhoun PS, Elbogen EB, Beckham JC, Pugh MJ, Kimbrel NA (2022) Comparing psychosocial functioning, suicide risk, and nonsuicidal self-injury between veterans with probable posttraumatic stress disorder and alcohol use disorder. J Affect Disord 308:10\u201318. https:\/\/doi.org\/10.1016\/j.jad.2022.04.006","journal-title":"J Affect Disord"},{"issue":"3","key":"3054_CR28","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1080\/13811118.2019.1635930","volume":"24","author":"C Hausman","year":"2020","unstructured":"Hausman C, Meffert BN, Mosich MK, Heinz AJ (2020) Impulsivity and cognitive flexibility as neuropsychological markers for suicidality: a multi-modal investigation among military veterans with alcohol use disorder and PTSD. Arch Suicide Res 24(3):313\u2013326. https:\/\/doi.org\/10.1080\/13811118.2019.1635930","journal-title":"Arch Suicide Res"},{"issue":"11","key":"3054_CR29","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1001\/jamapsychiatry.2021.2332","volume":"78","author":"B Nichter","year":"2021","unstructured":"Nichter B, Hill ML, Na PJ, Kline AC, Norman SB, Krystal JH, Southwick SM, Pietrzak RH (2021) Prevalence and trends in suicidal behavior among US military veterans during the COVID-19 pandemic. JAMA Psychiatry 78(11):1218\u20131227. https:\/\/doi.org\/10.1001\/jamapsychiatry.2021.2332","journal-title":"JAMA Psychiatry"},{"key":"3054_CR30","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.drugalcdep.2018.09.011","volume":"194","author":"E Straus","year":"2019","unstructured":"Straus E, Norman SB, Haller M, Southwick SM, Hamblen JL, Pietrzak RH (2019) Differences in protective factors among U.S. veterans with posttraumatic stress disorder, alcohol use disorder, and their comorbidity: results from the National health and resilience in veterans study. Drug Alcohol Depend 194:6\u201312. https:\/\/doi.org\/10.1016\/j.drugalcdep.2018.09.011","journal-title":"Drug Alcohol Depend"},{"key":"3054_CR31","doi-asserted-by":"publisher","DOI":"10.1111\/acer.15313","author":"TO Walton","year":"2024","unstructured":"Walton TO, Graupensperger S, Walker DD, Kaysen D (2024) Alcohol use disorder as a moderator of the relationship between posttraumatic stress disorder and suicidality among military personnel. Alcohol Clin Exp Res. https:\/\/doi.org\/10.1111\/acer.15313","journal-title":"Alcohol Clin Exp Res"},{"issue":"4","key":"3054_CR32","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s40429-023-00511-5","volume":"10","author":"TC Saraiya","year":"2023","unstructured":"Saraiya TC, Back SE, Jarnecke AM, Blakey SM, Bauer AG, Brown DG, Ruglass LM, Killeen T, Hien DA (2023) Sex and gender differences in co-occurring alcohol use disorder and PTSD. Curr Addict Rep 10(4):617\u2013627. https:\/\/doi.org\/10.1007\/s40429-023-00511-5","journal-title":"Curr Addict Rep"},{"issue":"7","key":"3054_CR33","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1001\/jamapsychiatry.2021.0336","volume":"78","author":"KS Kendler","year":"2021","unstructured":"Kendler KS, Ohlsson H, Sundquist J, Sundquist K (2021) Family genetic risk scores and the genetic architecture of major affective and psychotic disorders in a Swedish National sample. JAMA Psychiatr 78(7):735\u2013743. https:\/\/doi.org\/10.1001\/jamapsychiatry.2021.0336","journal-title":"JAMA Psychiatr"},{"issue":"1","key":"3054_CR34","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-021-01454-z","volume":"11","author":"KS Kendler","year":"2021","unstructured":"Kendler KS, Ohlsson H, Sundquist J, Sundquist K (2021) The patterns of family genetic risk scores for eleven major psychiatric and substance use disorders in a Swedish national sample. Transl Psychiatry 11(1):326. https:\/\/doi.org\/10.1038\/s41398-021-01454-z","journal-title":"Transl Psychiatry"},{"key":"3054_CR35","doi-asserted-by":"publisher","unstructured":"Krebs MD, Appadurai V, Hellberg K-L, Ohlsson H, Steinbach J, Petersen E, Consortium iS, Werge T, Sundquist J, Sundquist K, Cai N, Zaitlen N, Dahl A, Vilhjalmsson B, Flint J, Bacanu S-A, Schork AJ, Kendler KS (2023) The relationship between genotype- and phenotype-based estimates of genetic liability to human psychiatric disorders, in practice and in theory. medRxiv. https:\/\/doi.org\/10.1101\/2023.06.19.23291606","DOI":"10.1101\/2023.06.19.23291606"},{"issue":"3","key":"3054_CR36","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1192\/bjp.bp.110.081331","volume":"197","author":"KS Kendler","year":"2010","unstructured":"Kendler KS, Gardner CO (2010) Interpretation of interactions: guide for the perplexed. Br J Psychiatry 197(3):170\u2013171. https:\/\/doi.org\/10.1192\/bjp.bp.110.081331","journal-title":"Br J Psychiatry"},{"key":"3054_CR37","volume-title":"RStudio: Integrated Development Environment for R","author":"Team P","year":"2023","unstructured":"Team P (2023) RStudio: Integrated Development Environment for R. Posit Software, PBC, Boston, MA"},{"issue":"2","key":"3054_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v038.i02","volume":"38","author":"TH Scheike","year":"2011","unstructured":"Scheike TH, Zhang M-J (2011) Analyzing competing risk data using the R timereg package. J Stat Softw 38(2):1\u201315. https:\/\/doi.org\/10.18637\/jss.v038.i02","journal-title":"J Stat Softw"},{"issue":"6","key":"3054_CR39","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1111\/add.14565","volume":"114","author":"TL Simpson","year":"2019","unstructured":"Simpson TL, Rise P, Browne KC, Lehavot K, Kaysen D (2019) Clinical presentations, social functioning, and treatment receipt among individuals with comorbid life-time PTSD and alcohol use disorders versus drug use disorders: findings from NESARC-III. Addiction 114(6):983\u2013993. https:\/\/doi.org\/10.1111\/add.14565","journal-title":"Addiction"},{"issue":"2","key":"3054_CR40","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1177\/01454455211033517","volume":"46","author":"M Zegel","year":"2022","unstructured":"Zegel M, Lebeaut A, Healy N, Tran JK, Vujanovic AA (2022) Mental health correlates of probable posttraumatic stress disorder, probable alcohol use disorder, and their co-occurrence among firefighters. Behav Modif 46(2):395\u2013421. https:\/\/doi.org\/10.1177\/01454455211033517","journal-title":"Behav Modif"},{"issue":"3","key":"3054_CR41","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.janxdis.2014.02.004","volume":"28","author":"SM Rojas","year":"2014","unstructured":"Rojas SM, Bujarski S, Babson KA, Dutton CE, Feldner MT (2014) Understanding PTSD comorbidity and suicidal behavior: associations among histories of alcohol dependence, major depressive disorder, and suicidal ideation and attempts. J Anxiety Disord 28(3):318\u2013325. https:\/\/doi.org\/10.1016\/j.janxdis.2014.02.004","journal-title":"J Anxiety Disord"},{"issue":"6","key":"3054_CR42","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1007\/s00127-017-1374-0","volume":"52","author":"CM Chen","year":"2017","unstructured":"Chen CM, Yoon YH, Harford TC, Grant BF (2017) Dimensionality of DSM-5 posttraumatic stress disorder and its association with suicide attempts: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol 52(6):715\u2013725. https:\/\/doi.org\/10.1007\/s00127-017-1374-0","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"3","key":"3054_CR43","doi-asserted-by":"publisher","first-page":"378","DOI":"10.15288\/jsad.22-00209","volume":"84","author":"AB Amstadter","year":"2023","unstructured":"Amstadter AB, Lonn SL, Sundquist J, Kendler KS, Sundquist K (2023) Testing phenotypic models of posttraumatic stress disorder and alcohol use disorder comorbidity using longitudinal registry data. J Stud Alcohol Drugs 84(3):378\u2013388. https:\/\/doi.org\/10.15288\/jsad.22-00209","journal-title":"J Stud Alcohol Drugs"},{"issue":"5","key":"3054_CR44","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1002\/jts.22521","volume":"33","author":"SE Hawn","year":"2020","unstructured":"Hawn SE, Cusack SE, Amstadter AB (2020) A systematic review of the self-medication hypothesis in the context of posttraumatic stress disorder and comorbid problematic alcohol use. J Trauma Stress 33(5):699\u2013708. https:\/\/doi.org\/10.1002\/jts.22521","journal-title":"J Trauma Stress"},{"issue":"2","key":"3054_CR45","doi-asserted-by":"publisher","first-page":"113","DOI":"10.35946\/arcr.v39.2.02","volume":"39","author":"NDL Smith","year":"2018","unstructured":"Smith NDL, Cottler LB (2018) The epidemiology of post-traumatic stress disorder and alcohol use disorder. Alcohol Res 39(2):113\u2013120","journal-title":"Alcohol Res"},{"issue":"3","key":"3054_CR46","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1080\/j.1440-1614.2000.00691.x","volume":"34","author":"AL Beautrais","year":"2000","unstructured":"Beautrais AL (2000) Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatry 34(3):420\u2013436. https:\/\/doi.org\/10.1080\/j.1440-1614.2000.00691.x","journal-title":"Aust N Z J Psychiatry"},{"issue":"8","key":"3054_CR47","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1176\/ajp.153.8.1009","volume":"153","author":"AL Beautrais","year":"1996","unstructured":"Beautrais AL, Joyce PR, Mulder RT, Fergusson DM, Deavoll BJ, Nightingale SK (1996) Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: a case-control study. Am J Psychiatry 153(8):1009\u20131014. https:\/\/doi.org\/10.1176\/ajp.153.8.1009","journal-title":"Am J Psychiatry"},{"issue":"11","key":"3054_CR48","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/j.jpsychires.2011.06.002","volume":"45","author":"P Qin","year":"2011","unstructured":"Qin P (2011) The impact of psychiatric illness on suicide: differences by diagnosis of disorders and by sex and age of subjects. J Psychiatr Res 45(11):1445\u20131452. https:\/\/doi.org\/10.1016\/j.jpsychires.2011.06.002","journal-title":"J Psychiatr Res"},{"issue":"3","key":"3054_CR49","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.comppsych.2013.10.007","volume":"55","author":"FN Briere","year":"2014","unstructured":"Briere FN, Rohde P, Seeley JR, Klein D, Lewinsohn PM (2014) Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. Compr Psychiatry 55(3):526\u2013533. https:\/\/doi.org\/10.1016\/j.comppsych.2013.10.007","journal-title":"Compr Psychiatry"},{"issue":"12","key":"3054_CR50","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0265287","volume":"17","author":"VN Onaemo","year":"2022","unstructured":"Onaemo VN, Fawehinmi TO, D\u2019Arcy C (2022) Risk of suicide ideation in comorbid substance use disorder and major depression. PLoS One 17(12):e0265287. https:\/\/doi.org\/10.1371\/journal.pone.0265287","journal-title":"PLoS One"},{"key":"3054_CR51","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.jad.2015.08.029","volume":"187","author":"PC Britton","year":"2015","unstructured":"Britton PC, Stephens B, Wu J, Kane C, Gallegos A, Ashrafioun L, Tu X, Conner KR (2015) Comorbid depression and alcohol use disorders and prospective risk for suicide attempt in the year following inpatient hospitalization. J Affect Disord 187:151\u2013155. https:\/\/doi.org\/10.1016\/j.jad.2015.08.029","journal-title":"J Affect Disord"},{"key":"3054_CR52","doi-asserted-by":"publisher","first-page":"e76","DOI":"10.1017\/S0033291725000546","volume":"55","author":"AB Amstadter","year":"2025","unstructured":"Amstadter AB, Abrahamsson L, Hart JE, Sundquist J, Sundquist K, Kendler KS (2025) What is the role of paternal genetic transmission on risk for PTSD and internalizing and externalizing disorders? Psychol Med 55:e76. https:\/\/doi.org\/10.1017\/S0033291725000546","journal-title":"Psychol Med"},{"key":"3054_CR53","unstructured":"Kendler KS, Ohlsson H, Amstadter AB, Sundquist J, Sundquist K (2025) The typology of common psychiatric and substance use disorders as depicted by genetic maps. Under review at American Journal of Psychiatry"},{"key":"3054_CR54","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.16m11364","author":"C Blanco","year":"2018","unstructured":"Blanco C, Hoertel N, Wall MM, Franco S, Peyre H, Neria Y, Helpman L, Limosin F (2018) Toward understanding sex differences in the prevalence of posttraumatic stress disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. https:\/\/doi.org\/10.4088\/JCP.16m11364","journal-title":"J Clin Psychiatry"},{"key":"3054_CR55","doi-asserted-by":"publisher","unstructured":"Back SE, Foa EB, Killeen TK, Mills KL, Teesson M, Cotton BD, Carroll KM, Brady KT (2014) Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): Therapist Guide. https:\/\/doi.org\/10.1093\/med:psych\/9780199334537.001.0001","DOI":"10.1093\/med:psych\/9780199334537.001.0001"},{"issue":"7","key":"3054_CR56","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1001\/jama.2012.9071","volume":"308","author":"KL Mills","year":"2012","unstructured":"Mills KL, Teesson M, Back SE, Brady KT, Baker AL, Hopwood S, Sannibale C, Barrett EL, Merz S, Rosenfeld J, Ewer PL (2012) Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a randomized controlled trial. JAMA 308(7):690\u2013699. https:\/\/doi.org\/10.1001\/jama.2012.9071","journal-title":"JAMA"},{"key":"3054_CR57","unstructured":"National Institute for Health and Care Excellence (2022) Self-harm: assessment, management and preventing recurrence. https:\/\/www.nice.org.uk\/guidance\/ng225\/chapter\/Recommendations#risk-assessment-tools-and-scales. 2025"},{"issue":"5","key":"3054_CR58","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1192\/bjp.2023.113","volume":"223","author":"F Mughal","year":"2023","unstructured":"Mughal F, Burton FM, Fletcher H, Lascelles K, O\u2019Connor RC, Rae S, Thomson AB, Kapur N (2023) New guidance for self-harm: an opportunity not to be missed. Br J Psychiatry 223(5):501\u2013503. https:\/\/doi.org\/10.1192\/bjp.2023.113","journal-title":"Br J Psychiatry"},{"key":"3054_CR59","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1016\/j.jpsychires.2022.09.050","volume":"155","author":"K Kusuma","year":"2022","unstructured":"Kusuma K, Larsen M, Quiroz JC, Gillies M, Burnett A, Qian J, Torok M (2022) The performance of machine learning models in predicting suicidal ideation, attempts, and deaths: a meta-analysis and systematic review. J Psychiatr Res 155:579\u2013588. https:\/\/doi.org\/10.1016\/j.jpsychires.2022.09.050","journal-title":"J Psychiatr Res"},{"issue":"6","key":"3054_CR60","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1192\/bjp.bp.116.182717","volume":"210","author":"G Carter","year":"2017","unstructured":"Carter G, Milner A, McGill K, Pirkis J, Kapur N, Spittal MJ (2017) Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br J Psychiatry 210(6):387\u2013395. https:\/\/doi.org\/10.1192\/bjp.bp.116.182717","journal-title":"Br J Psychiatry"},{"issue":"4","key":"3054_CR61","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1192\/bjp.bp.115.170050","volume":"209","author":"MK Chan","year":"2016","unstructured":"Chan MK, Bhatti H, Meader N, Stockton S, Evans J, O\u2019Connor RC, Kapur N, Kendall T (2016) Predicting suicide following self-harm: systematic review of risk factors and risk scales. Br J Psychiatry 209(4):277\u2013283. https:\/\/doi.org\/10.1192\/bjp.bp.115.170050","journal-title":"Br J Psychiatry"},{"issue":"1","key":"3054_CR62","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1176\/appi.ps.202100611","volume":"74","author":"CJ Bryan","year":"2023","unstructured":"Bryan CJ, Allen MH, Hoge CW (2023) Weighing the costs and benefits of universal suicide risk screening in primary care: an evidence-based approach. Psychiatr Serv 74(1):79\u201381. https:\/\/doi.org\/10.1176\/appi.ps.202100611","journal-title":"Psychiatr Serv"},{"issue":"23","key":"3054_CR63","doi-asserted-by":"publisher","first-page":"2057","DOI":"10.1001\/jama.2023.9297","volume":"329","author":"USPST Force","year":"2023","unstructured":"Force USPST, Barry MJ, Nicholson WK, Silverstein M, Chelmow D, Coker TR, Davidson KW, Davis EM, Donahue KE, Jaen CR, Li L, Ogedegbe G, Pbert L, Rao G, Ruiz JM, Stevermer JJ, Tsevat J, Underwood SM, Wong JB (2023) Screening for depression and suicide risk in adults: US preventive services task force recommendation statement. JAMA 329(23):2057\u20132067. https:\/\/doi.org\/10.1001\/jama.2023.9297","journal-title":"JAMA"}],"container-title":["Social Psychiatry and Psychiatric Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00127-026-03054-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00127-026-03054-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00127-026-03054-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:10:36Z","timestamp":1787803836000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00127-026-03054-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":63,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["3054"],"URL":"https:\/\/doi.org\/10.1007\/s00127-026-03054-y","relation":{},"ISSN":["0933-7954","1433-9285"],"issn-type":[{"value":"0933-7954","type":"print"},{"value":"1433-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]},"assertion":[{"value":"17 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We secured ethical approval from the Regional Ethical Review Board in Lund and no participant consent was required (No. 2008\/409 and later amendments). The study was performed been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.\u00a0The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","label":"Ethical statements","group":{"name":"EthicsHeading","label":"Declarations"}}]}}