title: Clustering Suicide Attempters: Impulsive-Ambivalent, Well-Planned, or Frequent.
abstract: Attempts to predict suicidal behavior within high-risk populations have so far shown insufficient accuracy. Although several psychosocial and clinical features have been consistently associated with suicide attempts, investigations of latent structure in well-characterized populations of suicide attempters are lacking.
  
  
  
  We analyzed a sample of 1,009 hospitalized suicide attempters that were recruited between 1999 and 2012. Eleven clinically relevant items related to the characteristics of suicidal behavior were submitted to a Hierarchical Ascendant Classification. Phenotypic profiles were compared between the resulting clusters. A decisional tree was constructed to facilitate the differentiation of individuals classified within the first 2 clusters.
  
  
  
  Most individuals were included in a cluster characterized by less lethal means and planning ("impulse-ambivalent"). A second cluster featured more carefully planned attempts ("well-planned"), more alcohol or drug use before the attempt, and more precautions to avoid interruptions. Finally, a small, third cluster included individuals reporting more attempts ("frequent"), more often serious or violent attempts, and an earlier age at first attempt. Differences across clusters by demographic and clinical characteristics were also found, particularly with the third cluster whose participants had experienced high levels of childhood abuse.
  
  
  
  Cluster analysis consistently supported 3 distinct clusters of individuals with specific features in their suicidal behaviors and phenotypic profiles that could help clinicians to better focus prevention strategies.
authors.affiliation: Inserm U1061, Hôpital La Colombière, Pavillon 42. 39 Av Charles Flauhault BP: 34493. 34093 Montpellier, France. jorgecastroman@gmail.com.|Inserm, U1061; University of Montpellier 1, Montpellier, F-34000 France.|Department of Psychiatry, CHRU Nimes, France.|Fondation Fondamental, Créteil, France.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez-Castroman
authors.affiliation: Clinical Research and Epidemiology Unit, Medical Information Department, Montpellier University Hospital, Montpellier, France.
authors.forename: Erika
authors.initials: E
authors.lastname: Nogue
authors.affiliation: Inserm, U1061; University of Montpellier 1, Montpellier, F-34000 France.|Fondation Fondamental, Créteil, France.|Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, France .
authors.forename: Sebastien
authors.initials: S
authors.lastname: Guillaume
authors.affiliation: Clinical Research and Epidemiology Unit, Medical Information Department, Montpellier University Hospital, Montpellier, France.|Clinical Investigation Center 1411, INSERM, Montpellier, France.
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Picot
authors.affiliation: Inserm, U1061; University of Montpellier 1, Montpellier, F-34000 France.|Fondation Fondamental, Créteil, France.|Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, France .
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D015331:Cohort Studies; D003663:Decision Trees; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires