title: Are predictors of future suicide attempts and the transition from suicidal ideation to suicide attempts shared or distinct: a 12-month prospective study among patients with depressive disorders.
abstract: Our study aimed to examine the interplay between clinical and social predictors of future suicide attempt and the transition from suicidal ideation to suicide attempt in depressive disorders. Sixty-six Malaysian inpatients with a depressive disorder were assessed at index admission and within 1 year for suicide attempt, suicidal ideation, depression severity, life event changes, treatment history and relevant clinical and socio-demographic factors. One-fifth of suicidal ideators transitioned to a future suicide attempt. All future attempters (12/66) had prior ideation and 83% of attempters had a prior attempt. The highest risk for transitioning from ideation to attempt was 5 months post-discharge. Single predictor models showed that previous psychiatric hospitalization and ideation severity were shared predictors of future attempt and ideation to attempt transition. Substance use disorders (especially alcohol) predicted future attempt and approached significance for the transition process. Low socio-economic status predicted the transition process while major personal injury/illness predicted future suicide attempt. Past suicide attempt, subjective depression severity and medication compliance predicted only future suicide attempt. The absence of prior suicide attempt did not eliminate the risk of future attempt. Given the limited sample, future larger studies on mechanisms underlying the interactions of such predictors are needed.
authors.affiliation: Department of Psychiatry, National University of Malaysia Medical Centre (UKMMC), Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia. Electronic address: laifchan@gmail.com.
authors.forename: Lai Fong
authors.initials: LF
authors.lastname: Chan
authors.affiliation: Department of Community Medicine, National University of Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia.
authors.forename: Azhar Shah
authors.initials: AS
authors.lastname: Shamsul
authors.affiliation: Department of Psychiatry, National University of Malaysia Medical Centre (UKMMC), Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.
authors.forename: Thambu
authors.initials: T
authors.lastname: Maniam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000639:trends*; D055815:Young Adult
keywords: Clinical and social predictors; Future suicide attempt; Transition ideation to attempt