title: Personality disorders and health problems distinguish suicide attempters from completers in a direct comparison.
abstract: BACKGROUND
  Whether suicide attempters and completers represent the same population evaluated at different points along a progression towards suicide death, overlapping populations, or completely different populations is a problem still unresolved.
  
  
  METHODS
  446 Adult suicide attempters and knowledgeable collateral informants for 190 adult suicide probands were interviewed. Sociodemographic and clinical data was collected for both groups using semi-structured interviews and structured assessments. Univariate analyses and logistic regression models were conducted to explore the similarities and differences between suicide attempters and completers.
  
  
  RESULTS
  Univariate analyses yielded significant differences in sociodemographics, recent life events, impulsivity, suicide intent, and distribution of Axis I and II disorders. A logistic regression model aimed at distinguishing suicide completers from attempters properly classified 90% of subjects. The most significant variables that distinguished suicide from attempted suicide were the presence of narcissistic personality disorder (OR=21.4; 95% CI=6.8-67.7), health problems (OR=20.6; 95% CI=5.6-75.9), male sex (OR=9.6; 95% CI=4.42-20.9), and alcohol abuse (OR=5.5; 95% CI=2.3-14.2).
  
  
  CONCLUSIONS
  Our study shares the limitations of studies comparing suicide attempters and completers, namely that information from attempters can be obtained from the subject himself, whereas the assessment of completers depends on information from close family or friends. Furthermore, different semi-structured instruments assessed Axis I and Axis II disorders in suicide attempters and completers. Finally, we have no data on inter-rater reliability data.
  
  
  CONCLUSIONS
  Suicide completers are more likely to be male and suffer from alcohol abuse, health problems (e.g. somatic illness), and narcissistic personality disorder. The findings emphasize the importance of implementing suicide prevention programs tailored to suicide attempters and completers.
authors.affiliation: Department of Psychiatry, University of Seville, Seville, Spain.
authors.forename: Lucas
authors.initials: L
authors.lastname: Giner
authors.affiliation: Department of Psychiatry, MHC Villalba, IDIPHIM-Puerta de Hierro Hospital, CIBERSAM, Madrid, Spain. Electronic address: hmblasco@yahoo.es.
authors.forename: Hilario
authors.initials: H
authors.lastname: Blasco-Fontecilla
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, and the Mental Illness Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center New York, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Mercedes Perez-Rodriguez
authors.affiliation: Department of Psychiatry, Jimenez Diaz Foundation, Autonoma University, IIS, CIBERSAM, Madrid, Spain.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Garcia-Nieto
authors.affiliation: Department of Psychiatry, University of Seville, Seville, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Giner
authors.affiliation: Department of Psychiatry, University of Seville, Seville, Spain; Department of Psychiatry, Institute of Legal Medicine, Seville, Spain.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Guija
authors.affiliation: Department of Pathology, Institute of Legal Medicine, Seville, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rico
authors.affiliation: Department of Pathology, Institute of Legal Medicine, Seville, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Barrero
authors.affiliation: Department of Pathology, Institute of Legal Medicine, Ciudad Real and Toledo, Toledo, Spain.
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Luna
authors.affiliation: Mental Health Research Center at Eastern State Hospital, Lexington, Kentucky, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: de Leon
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Oquendo
authors.affiliation: Department of Psychiatry, Jimenez Diaz Foundation, Autonoma University, IIS, CIBERSAM, Madrid, Spain; Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-Garcia
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Alcohol abuse; Attempted suicide; Impulsivity; Personality disorder; Suicide