Factors associated with single versus multiple suicide attempts in depressive disorders

• Published in: Journal of affective disorders Vol. 277; pp. 306 - 312
• Main Authors: Tondo, Leonardo, Baldessarini, Ross J., Barbuti, Margherita, Colombini, Paola, Angst, Jules, Azorin, Jean-Michel, Bowden, Charles L., Mosolov, Sergey, Young, Allan H., Vieta, Eduard, Perugi, Giulio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2020
• Subjects: Bipolar disorder; Bipolar Disorder - drug therapy; Bipolar Disorder - epidemiology; Borderline Personality Disorder - epidemiology; Depressive Disorder - drug therapy; Depressive Disorder - epidemiology; Depressive episode; Female; Humans; Risk Factors; Suicidal Ideation; Suicide attempts; Suicide, Attempted; Suicide attempts; Bipolar disorder; Depressive episode
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2020.08.021

•Among depressed patients, women are more likely to attempt suicide multiple times.•Intensive suicidal behavior is associated with bipolar disorder and related features.•Repeated suicide attempts and mood-switching with ADs are frequently associated. Many risk factors for suicidal behavior have been identified. Much less has been done to associate risk factors with recurrence of suicidal behavior. We compared prevalence of 30 potential risk factors among 8496 depressive patient-subjects from the BRIDGE consortium with no (NSA, n = 6267), one (1SA, n = 1123), or repeated (≥2) suicide attempts (RSA, n = 1106). Prevalence of most factors ranked: RSA ≥ 1SA > NSA, with a notable opposite trend for the diagnosis of type II bipolar disorder (BD). Factors independently and significantly more present among RSA than 1SA subjects were: borderline personality, substance abuse, mood-switching with antidepressant treatment, female sex, and unsatisfactory response to antidepressant treatment. There also were notably strong associations of RSA with type I or probable BD and associated factors, including family history of BD, young onset, mixed and psychotic features. Potential effects of treatment on risk of suicidal acts could not be evaluated adequately, as well as associations between levels of suicidal behavior and eventual death by suicide. In a large cohort of depressive patients, there were significant associations not only with suicidal behavior generally, but also with the intensity of suicide attempts.