Citation

Blasco-Fontecilla H, Jaussent I, Olié E, Béziat S, Guillaume S, Artieda-Urrutia P, Baca-Garcia E, De Leon J, Courtet P. Prim. Care Companion CNS Disord. 2014; 16(4): 14m01633.

Affiliation

Department of Psychiatry, IDIPHIM-Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain (Drs Blasco-Fontecilla and Artieda-Urrutia); CIBERSAM (Dr Blasco-Fontecilla), Madrid, Spain; Inserm, U1061 and Université Montpellier I (Drs Jaussent, Olié, Guillaume, and Courtet and Ms Béziat), Montpellier, France; Psychiatric Emergency and Post Emergency Department, Centre Hospitalier Regional Universitaire Montpellier, Hôpital Lapeyronie, Montpellier, France (Drs Guillaume, Olié, and Courtet); Department of Psychiatry, IIS-FJD, CIBERSAM, Madrid, Spain (Dr Baca-Garcia); and Mental Health Research Center, Eastern State Hospital, Lexington, Kentucky (Dr de Leon).

Copyright

(Copyright © 2014, Physicians Postgraduate Press)

DOI

10.4088/PCC.14m01633

PMID

25664212

Abstract

OBJECTIVE: The characterization of major repeaters (individuals with ≥ 5 lifetime suicide attempts) is a neglected area of research. Our aim was to establish whether or not major repeaters are a distinctive suicidal phenotype, taking into account a wide range of potential competing risks including sociodemographic characteristics, personal and familial history, psychiatric diagnoses, and personality traits.

METHOD: This cross-sectional study included 372 suicide attempters admitted to a specialized unit for suicide attempters in Montpellier University Hospital, Montpellier, France, between October 12, 2000, and June 10, 2010. Logistic regression models controlling for potential confounders were used.

RESULTS: When compared with subjects who attempted suicide < 5 times, major repeaters were more likely to be female (odds ratio [OR] = 5.54; 95% CI, 1.41-21.81), to have a lower educational level (OR = 5.1; 95% CI, 1.55-17.2), to have lifetime diagnoses of anorexia nervosa (OR = 3.45; 95% CI, 1.10-10.84) and substance dependence (OR = 5.00; 95% CI, 1.37-18.27), and to have lower levels of anger expressed outward (OR = 0.17; 95% CI, 0.06-0.47) and higher levels of trait anger (OR = 2.82; 95% CI, 1.18-6.75). Major repeaters had significantly higher suicide risk (lethality) scores (OR = 2.14; 95% CI, 1.08-4.23).

CONCLUSION: Major repeaters are a distinctive suicidal phenotype characterized by a distinctive sociodemographic (ie, female gender, low education) and clinical profile (ie, trait anger, substance dependence, anorexia nervosa). If our results are replicated, specific preventive plans should be tailored to major repeaters.

Language: en