@article{ref1,
title="Predictors of relapse in high lethality suicide attempters: a six-month prospective study",
journal="Journal of affective disorders",
year="2020",
author="Aguglia, Andrea and Solano, Paola and Parisi, Valentina Maria and Asaro, Pietro and Caprino, Matilde and Trabucco, Alice and Amerio, Andrea and Amore, Mario and Serafini, Gianluca",
volume="271",
number="",
pages="328-335",
abstract="BACKGROUND: This study is aimed to investigate the association between clinical, metabolic, inflammatory and environmental (photoperiod defined as daily sunlight exposure) parameters and suicide re-attempts after the index suicide attempt. Possible predictors of suicide re-attempts were also explored.   METHODS: Overall, 432 subjects with suicide attempts, of which 79 relapsed within the following six months were included in this prospective study. We adopted the Joiner's definition of suicide lethality, as &quot;the acquired ability to enact lethal self-injury&quot;. The Cox regression was used to test the association between the mentioned variables and Kaplan-Meier plots showed the trend of suicide re-attempts.   RESULTS: Among participants, 30.8% committed a high-lethality suicide attempt. Cox regression confirmed the association between lifetime suicide attempts and number of suicide attempts in the study time-frame and suicide-reattempts. The longer photoperiod (Spring/Summer) was associated with suicide re-attempts, particularly patients with admission in June/July for the index event. Total cholesterol (TC), low-density lipo-protein cholesterol and c-reactive protein serum levels were significantly associated with suicide re-attempts but Cox regression confirmed only the association between lower TC serum levels and suicide re-attempt.   LIMITATIONS: Patients' seasonal environment, psychological factors, presence of acute life-events fostering the suicidal crisis and detailed medical history have been not investigated. <br><br>FINDINGS were derived from a single psychiatric unit.   CONCLUSIONS: Lifetime suicide attempts, higher number of previous suicide attempts, lower total cholesterol levels, and suicide attempt during longer photoperiod were significant predictors of suicide re-attempts. Further studies are needed in order to better characterize single- vs. multiple suicide attempter's profiles.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2020.04.006",
url="http://dx.doi.org/10.1016/j.jad.2020.04.006"
}