Risk factors of suicide re-attempt: A two-year prospective study

J Affect Disord. 2024 Jul 1:356:535-544. doi: 10.1016/j.jad.2024.04.058. Epub 2024 Apr 22.

Abstract

Background: History of suicide attempt (SA) is the strongest predictor of a new SA and suicide. It is primordial to identify additional risk factors of suicide re-attempt. The aim of this study was to identify risk factors of suicide re-attempt in patients with recent SA followed for 2 years.

Methods: In this multicentric cohort of adult inpatients, the median of the index SA before inclusion was 10 days. Clinicians assessed a large panel of psychological dimensions using validated tools. Occurrence of a new SA or death by suicide during the follow-up was recorded. A cluster analysis was used to identify the dimensions that best characterized the population and a variable "number of personality traits" was created that included the three most representative traits: anxiety, anger, and anxious lability. Risk factors of re-attempt were assessed with adjusted Cox regression models.

Results: Among the 379 patients included, 100 (26.4 %) re-attempted suicide and 6 (1.6 %) died by suicide. The two major risk factors of suicide re-attempt were no history of violent SA and presenting two or three personality traits among trait anxiety, anger and anxious lability.

Limitations: It was impossible to know if treatment change during follow-up occur before or after the re-attempt.

Discussion: One of the most important predictors of re-attempt in suicide attempters with mood disorders, was the presence of three personality traits (anger, anxiety, and anxious lability). Clinicians should provide close monitoring to patients presenting these traits and proposed treatments specifically targeting these dimensions, especially anxiety.

Keywords: Anger; Anxiety; Anxious lability; Re-attempt; Suicide; Suicide attempt.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anger*
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Personality
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Suicide, Attempted* / psychology
  • Suicide, Attempted* / statistics & numerical data