Risk Factors for Reattempt and Suicide Within 6 Months After an Attempt in the French ALGOS Cohort: A Survival Tree Analysis
aUniversity of Lille, Inserm, CHU Lille, U1172 – LilNCog—Lille Neuroscience & Cognition, Lille, France
bUniversity of Lille, CHU Lille, ULR 2694, CERIM, Public Health Department, Lille, France
cCentre National de Ressources et de Résilience (CN2R), Lille, France
*Corresponding author: Alice Demesmaeker, MD, MSc, Hôpital Fontan, CHU de Lille, F-59037, Lille Cedex, France (alice.demesmaeker@chru-lille.fr).
J Clin Psychiatry. 2021;82(1):20m13589ABSTRACT
Objective: Understanding the cumulative effect of several risk factors involved in suicidal behavior is crucial for the development of effective prevention plans. The objective of this study is to provide clinicians with a simple predictive model of the risk of suicide attempts and suicide within 6 months after suicide attempt.
Methods: A prospective observational cohort of 972 subjects, included from January 26, 2010, to February 28, 2013, was used to perform a survival tree analysis with all sociodemographic and clinical variables available at inclusion. The results of the decision tree were then used to define a simple predictive algorithm for clinicians.
Results: The results of survival tree analysis highlighted 3 subgroups of patients with an increased risk of suicide attempt or death by suicide within 6 months after suicide attempt: patients with alcohol use disorder and a previous suicide attempt with acute alcohol use (risk ratio [RR] = 2.92; 95% CI, 2.08 to 4.10), patients with anxiety disorders (RR = 0.98; 95% CI, 0.69 to 1.39), and patients with a history of more than 2 suicide attempts in the past 3 years (RR = 2.11; 95% CI, 1.25 to 3.54). The good prognosis group comprised all other patients.
Conclusions: By using a data-driven method, this study identified 4 clinical factors interacting together to reduce or increase the risk of recidivism. These combinations of risk factors allow for a better evaluation of a subject’s suicide risk in clinical practice.
Trial Registration: ClinicalTrials.gov identifier: NCT01123174
J Clin Psychiatry 2021;82(1):20m13589
To cite: Demesmaeker A, Chazard E, Vaiva G, et al. Risk factors for reattempt and suicide within 6 months after an attempt in the French ALGOS cohort: a survival tree analysis. J Clin Psychiatry. 2021;82(1):20m13589.
To share: https://doi.org/10.4088/JCP.20m13589