Risk factors of suicide re-attempt: A two-year prospective study
B Nobile 1 , I Jaussent 2 , J P Kahn 3 , M Leboyer 4 , N Risch 5 , E Olié 6 , Ph Courtet 6
Affiliations
1 Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France. Electronic address: benedicte.nobile@gmail.com.
2 Institute for Neurosciences of Montpellier INM, INSERM Montpellier, University of Montpellier, Montpellier, France.
3 Université de Lorraine, Nancy, France; Clinique Soins-Etudes de Vitry le François, Fondation Sant'e des Etudiants de France (FSEF), Paris, France.
4 FondaMental Foundation, France; Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France.
5 IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.
6 Department of Emergency Psychiatry and Acute Care, CHU, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, France. PMID: 38657762
DOI: 10.1016/j.jad.2024.04.058 Free article
Multicenter 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.
lundi 25 novembre 2024
ETUDE RECHERCHE Risk factors of suicide re-attempt: A two-year prospective study
