Posttraumatic Stress Disorder following childhood abuse increases the severity of suicide attempts

Jorge Lopez-Castroman^a^,^b^,^c^,Isabelle Jaussent^a, Severine Beziat^a, Sebastien Guillaume^a^,^c^,^d, Enrique Baca-Garcia^b^,^e, Emilie Olié^a^,^c^,^d, Philippe Courtet^a^,^c^,^d

^a Inserm U1061, Ho^pital La Colombiere, Montpellier, France
^b IIS-Fundacion Jimenez Diaz, Department of Psychiatry, CIBERSAM, Madrid, Spain
^c Department of Emergency Psychiatry, CHRU Montpellier, France
^d University of Montpellier 1, Montpellier, France
^e Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA

Received 28 February 2014, Revised 1 July 2014, Accepted 7 August 2014, Available online 15 August 2014
Journal of Affective Disorders

Volume 170, 1 January 2015, Pages 7–14

Abstract
Objective

Posttraumatic Stress Disorder (PTSD) and childhood abuse are both consistently associated with a higher risk for suicide attempts. We hypothesize that among patients reporting childhood abuse, PTSD diagnoses are correlated with an increased severity of suicidal features.
Method

We investigated 726 adult patients who had attempted suicide. These participants were assessed on lifetime clinical diagnoses and childhood abuse. The association of PTSD and childhood abuse dimensions with age at first suicide attempt, number of suicide attempts, violent attempts, serious attempts and suicide intent was studied. An adjusted multinomial logistic regression was performed to ascertain if childhood abuse and PTSD increased the severity of the suicidal behavior when combined.
Results

Several types of childhood abuse (emotional, physical and sexual abuse) when combined with a lifetime diagnosis of PTSD showed an increased risk for more suicide attempts, serious attempts, and a higher level of suicidal intent compared with the absence of any or both risk factors.
Conclusion

The combination of PTSD and childhood abuse should be investigated in clinical settings due to an augmented risk for more severe suicidal behavior.
keywords
Posttraumatic Stress Disorders;
Suicidal behavior;
Childhood abuse

http://www.sciencedirect.com/science/article/pii/S0165032714004868