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Abstract
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Background and Objective: Previous suicide attempt (SA) is one of the greatest risks for completed suicide. The national data of SA reporting indicated a steady increase in the number of SA over the past 16 years in Taiwan. The present study aimed to investigate the association between psychological distress and subsequent non-fatal attempt within one year in a nationwide population-based cohort of suicide attempters.
METHODS: The participants comprised the attempters reported first time to the Taiwan National Suicide Surveillance System (NSSS) during 2019-2021, who completed the five-item Brief Symptom Rating Scale (BSRS-5) at the index event. Kaplan-Meier survival curve analysis with log-rank test and Cox regression model was used to examine the association between psychological distress and the cumulative incidence of non-fatal re-attempts in the following year.
RESULTS: In total, 49,509 individuals (66.3% females) were recruited and 9,163 (18.5%) of them had subsequent non-fatal suicide attempts within one year. The females presented significantly higher levels of psychological distress and suicidal ideation. Survival curves analysis and Cox regression model revealed that the level of individual psychological distress (i.e., suicidal ideation (SI), depression, inferiority, anxiety, hostility. and insomnia) and general distress (BSRS-5 total scores) were positively correlated with the incidence of subsequent non-fatal reattempts with dose-response relationship at five time-points within one year (e.g., highest HR=2.10 for SI, 1.98 for depression and 1.95 for BSRS-5).
CONCLUSION: The study revealed that psychological distress was a significant and sustained predictor of the first non-fatal reattempt in one year after the index event. The results imply that suicide is not only an acute crisis but also a chronic mental problem. The BSRS-5 can triage psychological distress and accordingly provide a pertinent person-centered approach to prevent suicide.
Language: zh |