title: Risk and protective factors predicting multiple suicide attempts.
abstract: This study compared demographical and clinical variables between first and multiple suicide attempters and investigated risk and protective factors predicting multiple attempts. 228 patients visiting emergency department after attempting suicide were divided into two groups: first attempter (n=148, 64.9%) and multiple attempter (n=80, 35.1%). Demographic variables, clinical characteristics, factors related with suicide behavior, and psychiatric resources between two groups were compared. Multivariate logistic regression analysis was conducted to investigate risk and protective factors predicting multiple attempts. The results showed that multiple attempters were younger, not married, more severe in psychopathology (e.g., psychiatric disorder, personality disorder, lower function, and suicide family history) and suicidality (e.g., repetitive/severe/continuous suicide ideation), and lower in psychiatric resources (e.g., interpersonal stress/conflict, conflicting interpersonal relationship, socially isolated, lower personal achievement, and lower ability to control emotion) than first attempters. Suicide ideation severity and conflicting interpersonal relationships predicted multiple suicide attempts, whereas past year's highest global functioning score and age over 45 protected against multiple suicide attempts. This study demonstrated that multiple suicide attempters have more severe clinical profile than first suicide attempters. Moreover, decreasing severity of suicide ideation, improving interpersonal relationships, and enhancing functioning level of suicide attempters might be important in preventing them from re-attempting suicide.
authors.affiliation: Department of Emergency Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
authors.forename: Kyoung Ho
authors.initials: KH
authors.lastname: Choi
authors.forename: Sheng-Min
authors.initials: SM
authors.lastname: Wang
authors.forename: Bora
authors.initials: B
authors.lastname: Yeon
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Suh
authors.forename: Youngmin
authors.initials: Y
authors.lastname: Oh
authors.forename: Hae-Kook
authors.initials: HK
authors.lastname: Lee
authors.forename: Yong-Sil
authors.initials: YS
authors.lastname: Kweon
authors.forename: Chung Tai
authors.initials: CT
authors.lastname: Lee
authors.forename: Kyoung-Uk
authors.initials: KU
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D005544:Forecasting; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008875:Middle Aged; D010552:Personality Assessment; D010554:Personality Disorders; D010555:Personality Inventory; D011203:Poverty / Q000523:psychology; D065840:Protective Factors; D011599:Psychopathology; D018570:Risk Assessment; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Demography; Mood disorder; Self-injurious behavior