title: Predictive value of psychological characteristics and suicide history on medical lethality of suicide attempts: A follow-up study of hospitalized patients.
abstract: This study examined the role of mental pain, communication difficulties, and suicide history in predicting the medical severity of follow-up suicide attempts.
  
  
  
  The cohort included 153 consecutive psychiatric in-patients who participated in earlier studies 1-9 years previously. Fifty-three had a history of a medically serious suicide attempt (MSSA), 64 had a history of a medically non-serious suicide attempt (MNSSA), and 36 had no history of suicide. A MSSA was defined as a suicide attempt that warranted hospitalization for at least 24h and extensive medical treatment. Participants completed a battery of instruments measuring mental pain and communication difficulties. Findings were analyzed in relation to follow-up suicide attempts and their severity.
  
  
  
  Fifty-three patients (35.5%) had attempted suicide: 15 (9.9%) a MSSA (including 5 fatalities) and 38 (25%) a MNSSA. The medical severity of the index attempt and level of hopelessness at the index attempt were significantly correlated with medical severity of the follow-up attempt. In younger patients, high levels of depression and self-disclosure predicted the medical severity of the follow-up attempt. In patients with relatively low hopelessness, the medical severity of the attempt increased with the level of self-disclosure.
  
  
  
  (i) Possibly incomplete patient information, as some of the patients who participated in the index studies could not be located. (ii) Relatively small group of patients with an index MSSA.
  
  
  
  Patients who have made a suicide attempt should be assessed for medical severity of the attempt, hopelessness, and communication difficulties, which are important factors in follow-up attempts.
authors.affiliation: Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel. Electronic address: ruthtrakh@gmail.com.
authors.forename: Ruth
authors.initials: R
authors.lastname: Trakhtenbrot
authors.affiliation: Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; Department of Clinical Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Jaffa 86162, Israel.
authors.forename: Yari
authors.initials: Y
authors.lastname: Gvion
authors.affiliation: Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel.
authors.forename: Yossi
authors.initials: Y
authors.lastname: Levi-Belz
authors.affiliation: Department of Clinical Psychology, Bar Ilan University, Ramat Gan 5290002, Israel.
authors.forename: Netta
authors.initials: N
authors.lastname: Horesh
authors.affiliation: Geha Mental Health Center, Petach Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
authors.forename: Tsvi
authors.initials: T
authors.lastname: Fischel
authors.affiliation: The Psychiatric Division, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
authors.forename: Mark
authors.initials: M
authors.lastname: Weiser
authors.affiliation: Shalvata Mental Health Center, Hod Hasharon 45100, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Treves
authors.affiliation: Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva 49202, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
authors.forename: Alan
authors.initials: A
authors.lastname: Apter
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors; D012650:Self Disclosure; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Communication; Medically serious suicide attempt; Mental pain; Suicide