Risk of Repetition of Suicide Attempt, Suicide or all Deaths after an Episode of Attempted Suicide: A Register-Based Survival Analysis

2007 ◽  
Vol 41 (3) ◽  
pp. 257-265 ◽  
Author(s):  
Erik Christiansen ◽  
Børge Frank Jensen
Keyword(s):  
Mental Illness ◽  
Survival Analysis ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Cox Regression ◽  
High Risk Group ◽  
Suicide Attempters ◽  
Psychiatric Staff

Objective: This study was undertaken in order to estimate the incidence of repetition of suicide attempt, suicide and all deaths, and to analyse the influence of psychiatric illness and socio-demographic factors on these. Method: The study is a Danish register-based survival analysis that retrieved personal data on socio-economic, psychiatric and mortality conditions from various registers. Hazards were estimated using Cox regression with a time-dependence covariate. Suicide-attempters (2.614) and non-attempters (39.210)were analysed being matched by gender, age and place of residence. Results: The average follow-up period for suicide-attempters was 3.88 years, during which 271 (10.37%) of them died. By comparison, death occurred four times more often among suicide-attempters than among non-attempters. Suicide was far more common among attempters (61, 2.33%) than among non-attempters (16, 0.04%). A proportion of the attempters (31.33%) repeated their attempt within the follow-up period. The most reliable predictors for suicide and death were repetition, suicide attempt method and treatment for mental illness. The most reliable predictors for repetition were age, gender and mental illness. Discussion: Individuals with a history of suicide attempts form a well-defined high-risk group for suicide, and are in need of treatment immediately after the episode. Somatic and psychiatric staff must be informed about the risk factors for subsequent suicidal behaviour after an episode of attempted suicide. Furthermore, departments that are in contact with suicidal individuals need action plans to ensure that all such individuals are discharged to proper treatment immediately after the suicide attempt.

On the Stress/Parasuicide Or Parasuicide/Stress Relationship

1991 ◽  
Vol 68 (3_suppl) ◽  
pp. 1317-1318 ◽  
Author(s):  
George A. Clum ◽  
Richard L. Luscomb ◽  
Anne T. Patsiokas
Keyword(s):  
Chronic Stress ◽  
Predictive Validity ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
High Stress ◽  
Life Changes ◽  
Suicide Attempters ◽  
Follow Up Study ◽  
One Year

The question of whether high stress leads to attempting suicide (parasuicide) or suicide attempters are more likely to report high stress was examined in a one-year follow-up study of 98 persons, 47 of whom had attempted suicide. Cross-lagged panel correlations between stress and parasuicide provided both concurrent and predictive validity that stress as measured by life changes leads to parasuicide. A high relationship between stress at baseline and stress at follow-up provided support for the notion that some individuals experience chronic stress and that such individuals may be the ones at risk for future suicide attempts.

Suicide attempters: Clinical characteristics and management

2016 ◽  
Vol 33 (S1) ◽  
pp. S601-S601
Author(s):  
E. Gattoni ◽  
A. Feggi ◽  
C. Gramaglia ◽  
P. Bergamasco ◽  
I. Coppola ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Attempted Suicide ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Suicidal Risk ◽  
Suicide Attempters ◽  
History Of

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Construction of an Index for Predicting Suicide Attempts in Depressed Adolescents

1991 ◽  
Vol 159 (5) ◽  
pp. 676-682 ◽  
Author(s):  
C. W. M. Kienhorst ◽  
E. J. De Wilde ◽  
R. F. W. Diekstra ◽  
W. H. G. Wolters
Keyword(s):  
Logistic Regression ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Stepwise Logistic Regression ◽  
Regression Analyses ◽  
One Year

A group of 48 adolescents who recently attempted suicide and 66 depressed adolescents were compared on sociodemographic, behavioural, psychological and relational variables. The variables which proved significant were used in different combinations in stepwise logistic regression analyses, resulting in seven variables which served as the content of an index of risk. The sensitivity of the index was 90% and the specificity 83%. At one-year follow-up the occurrence of a suicide attempt correlated with score on the instrument.

scholarly journals A Naturalistic, European Multi-Center Clinical Study of Electrodermal Reactivity and Suicide Risk Among Patients With Depression

2022 ◽  
Vol 12 ◽  
Author(s):  
Vladimir Carli ◽  
Gergo Hadlaczky ◽  
Nuhamin Gebrewold Petros ◽  
Miriam Iosue ◽  
Patrizia Zeppegno ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Attempted Suicide ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Electrodermal Activity ◽  
Primary Diagnosis ◽  
Completed Suicide ◽  
Clinical Diagnoses ◽  
Reactivity Test

Background: Electrodermal hyporeactivity has been proposed as a marker of suicidal risk. The EUDOR-A study investigated the prevalence of electrodermal hyporeactivity among patients with depression and its association with attempted and completed suicide.Methods: Between August 2014 and March 2016, 1,573 in- and outpatients with a primary diagnosis of depression (active or remission phase) were recruited at 15 European psychiatric centers. Each patient was followed-up for 1 year. Electrodermal activity was assessed at baseline with the ElectroDermal Orienting Reactivity Test. Data on the sociodemographic characteristics, clinical diagnoses, and treatment of the subjects were also collected. The severity of the depressive symptoms was assessed through the Montgomery–Asberg Depression Rating Scale. Information regarding number, time, and method of suicide attempts was gathered at baseline and at the end of the 1-year follow-up. The same data were collected in case of completed suicide.Results: Hyporeactive patients were shown to be significantly more at risk of suicide attempt compared to reactive patients, both at baseline and follow-up. A sensitivity of 29.86% and a positive predictive value (PPV) of 46.77% were found for attempted suicide at baseline, while a sensitivity of 35.36% and a PPV of 8.92% were found for attempted suicide at follow-up. The sensitivity and PPV for completed suicide were 25.00 and 0.61%, respectively. However, when controlled for suicide attempt at baseline, the association between hyporeactivity and follow-up suicide attempt was no longer significant. The low number of completed suicides did not allow any analysis.

scholarly journals Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit: results from a 32-year follow-up study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038794
Author(s):  
Sara Probert-Lindström ◽  
Jonas Berge ◽  
Åsa Westrin ◽  
Agneta Öjehagen ◽  
Katarina Skogman Pavulans
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Major Depression ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Medical Emergency ◽  
Suicide Attempters

ObjectivesThe overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective.DesignProspective study with register-based follow-up for 21–32 years.SettingMedical emergency inpatient unit in the south of Sweden.Participants1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987–1998.Outcome measuresSuicide and all-cause mortality.ResultsAt follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide attempt as measured by SIS (Suicide Intent Scale) showed a non-proportional association with the hazard for suicide over time and was a relevant risk factor for suicide only within the first 5 years after an attempted suicide.ConclusionsThe risk of suicide after a suicide attempt persists for up to 32 years after the index attempt. A baseline diagnosis of psychosis or major depression or earlier suicide attempts continued to be relevant risk factors in the very long term. The SIS score is a better predictor of suicide risk at short term, that is, within 5 years than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.

Drugs and Suicide Attempts in Benin City, Nigeria

1984 ◽  
Vol 145 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Adego E. Eferakeya
Keyword(s):  
Mental Illness ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Predisposing Factors ◽  
Age Group ◽  
Benin City ◽  
Male Ratio ◽  
The Unemployed

SummaryA review of reported cases of attempted suicide in Benin City indicates that the incidence has not increased over the four-year period 1978 to 1981, during which the average crude suicide attempt rate was 7 per 100, 000. Eighty seven per cent of the attempters were under the age of 30, but the commonest age-group was 15–19 years (39.4 per cent). The female/male ratio was 1:1.2. The majority of the attempters (64 per cent) were students, housewives, and the unemployed. Ingestion of drugs (68 per cent) or of chemicals (20 per cent) was the predominant method. The major predisposing factors were mental illness (32 per cent) and conflicts with parents (24 per cent).

Repetition of Suicide Attempts

Crisis ◽  
2010 ◽  
Vol 31 (4) ◽  
pp. 194-201 ◽  
Author(s):  
José M. Bertolote ◽  
Alexandra Fleischmann ◽  
Diego De Leo ◽  
Michael R. Phillips ◽  
Neury J. Botega ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Emergency Departments ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Suicidal Behaviors ◽  
Suicide Attempters

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings. Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People’s Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt – the secondary outcome measure presented in this paper – were identified by follow-up calls or visits. Subsequent completed suicide – the primary outcome measure – has been reported in a previous paper. Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, χ² = 0.013; p = .909), but there were differences in rates across the five sites. Conclusions: This study from five low- and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.

The Incidence of Hospital-Treated Attempted Suicide in Oviedo, Spain

Crisis ◽  
2012 ◽  
Vol 33 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Luis Jimenez-Trevino ◽  
Pilar A. Saiz ◽  
Paul Corcoran ◽  
M. Paz Garcia-Portilla ◽  
Patricia Buron ◽  
...  
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Risk Group ◽  
Incidence Rates ◽  
Case Definition ◽  
High Risk Group ◽  
Sociodemographic Characteristics ◽  
Suicide Attempters ◽  
Men And Women ◽  
Male And Female

Background: The incidence of hospital-treated attempted suicide has not been well established in Spain. Aims: To determine the incidence of suicide attempters presenting to a hospital in Oviedo, Spain, to describe the nature of the suicidal behavior, and to identify sociodemographic subgroups of the population with high rates. Methods: All admitted to the Hospital Universitario Central de Asturias, Oviedo, during the period 1 May 2008 to 30 April 2009 were examined and those meeting the internationally-recognized case definition were identified. Results: A total of 308 suicide attempt presentations (39% male, 61% female) were made by 279 individuals. Almost 90% of the suicide attempts involved a drug overdose. The age-adjusted total, male, and female attempted suicide rates were 83, 66, and 99 per 100,000, respectively. The highest rate was among 35–44-year-olds for men and women (141.1 and 191.8 per 100,000, respectively). Incidence rates varied widely by sociodemographic characteristics with especially high rates among separated/divorced men (2.4%) and women (1.1%). Conclusions: The reported incidence of hospital-treated attempted suicide is below average in the European context but higher than that reported by previous Spanish studies. Persons separated or divorced constitute a high-risk group.

Epidemiological Trends in Attempted Suicide in Adolescents and Young Adults Between 1996 and 2004

Crisis ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Stephanie De Munck ◽  
Gwendolyn Portzky ◽  
Kees Van Heeringen
Keyword(s):  
Young Adults ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Epidemiological Studies ◽  
Adolescents And Young Adults ◽  
University Hospital ◽  
International Studies ◽  
Suicide Attempters ◽  
Increased Risk ◽  
Epidemiological Trends

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

Gender Differences in Suicidal Intent and Choice of Method Among Suicide Attempters

Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner
Keyword(s):  
Gender Differences ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
National Patient ◽  
Prevention Center ◽  
Suicide Prevention Center

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.

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