Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization
Abstract : Suicide attempts
(SAs) are a public health concern in adolescence. A brief
hospitalization is recommended, but access to inpatient wards is often
not available. In addition, numerous risk factors for SA recurrence have
been identified, but few studies have explored protective factors.
Here, we aimed to assess the role of both risk and protective factors on
SA relapse in a context of free access to inpatient services. We
performed a prospective follow-up study of 320 adolescents who were
hospitalized for an SA between January 2011 and December 2014 in France.
Assessments at baseline included socio-demographics, clinical
characteristics, temperament, reasons for living, spirituality, and
coping. Patients were re-evaluated at 6 months and 12 months for
depression severity and SA relapse. A total of 135 and 91 patients (78
girls, 12 boys, aged 13–17) were followed up at 6 and 12 months,
respectively. At the 12-month follow-up, 28 (30%) subjects had repeated
an SA. Adolescents who either had a history of SA or were receiving
psychotropic treatment at baseline were at higher risk of recurrence.
Several variables had a protective effect: (1) productive coping skills,
namely, working hard and achieving, physical recreation, and seeking
relaxing diversions; (2) a particular temperament trait, namely,
cooperativeness; and (3) having experienced more life events. We also
found a significant interaction: the higher the depression score during
follow-up, the lower the protective effect of productive coping. Our
findings confirm that a history of SA and seeking psychiatric care with
medication are risk factors for SA relapse. However, productive coping
strategies and cooperativeness are protective factors, and the
improvement of such strategies as well as treatment of persisting
depression should be a goal of psychotherapy treatment offered to
suicidal adolescents.
https://hal.archives-ouvertes.fr/hal-03109197
https://hal.archives-ouvertes.fr/hal-03109197
