Distinguishing the relevant features of frequent suicide attempters.
BACKGROUND
In spite of the high prevalence of suicide behaviours and the magnitude of the resultant burden, little is known about why individuals reattempt. We aim to investigate the relationships between clinical risk factors and the repetition of suicidal attempts.


METHODS
1349 suicide attempters were consecutively recruited in the Emergency Room (ER) of two academic hospitals in France and Spain. Patients were extensively assessed and demographic and clinical data obtained. Data mining was used to determine the minimal number of variables that blinded the rest in relation to the number of suicide attempts. Using this set, a probabilistic graph ranking relationships with the target variable was constructed.


RESULTS
The most common diagnoses among suicide attempters were affective disorders, followed by anxiety disorders. Risk of frequent suicide attempt was highest among middle-aged subjects, and diminished progressively with advancing age of onset at first attempt. Anxiety disorders significantly increased the risk of presenting frequent suicide attempts. Pathway analysis also indicated that frequent suicide attempts were linked to greater odds for alcohol and substance abuse disorders and more intensive treatment.


CONCLUSIONS
Novel statistical methods found several clinical features that were associated with a history of frequent suicide attempts. The identified pathways may promote new hypothesis-driven studies of suicide attempts and preventive strategies.
Department of Psychiatry at Fundacion Jimenez Diaz Hospital and Autonoma University, Avenida Reyes Católicos 2, 28040, Madrid, Spain. jorgecastroman@gmail.com
Jorge
J
Lopez-Castroman
Maria de las Mercedes
Mde L
Perez-Rodriguez
Isabelle
I
Jaussent
Analucia A
AA
Alegria
Antonio
A
Artes-Rodriguez
Peter
P
Freed
Sébastien
S
Guillaume
Fabrice
F
Jollant
Jose Miguel
JM
Leiva-Murillo
Alain
A
Malafosse
Maria A
MA
Oquendo
Mario
M
de Prado-Cumplido
Jeronimo
J
Saiz-Ruiz
Enrique
E
Baca-Garcia
Philippe
P
Courtet
D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012307:Risk Factors; D013030:Spain; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*