Predictive factors for recurrent suicide attempts: Evidence from the ACTION‐J study

Abstract

Aim Risk factors for attempted suicide have been widely studied. However, there is limited evidence on predictive factors for suicide reattempts. We aimed to identify these in suicide attempters admitted to emergency departments. Methods This is the second analysis from a randomized controlled multicenter trial, ACTION‐J. Patient characteristics were extracted from baseline demographic data and clinical data of participants. Predictive factors for a recurrent suicide attempt in each gender were examined using Cox proportional hazards regression analysis. Dependent variables were months from trial entry to the first reattempt. Independent variables were characteristics regarded as potential predictive factors. Results The study included 914 adults (400 men and 514 women). A visit to a psychiatrist within a month of the suicide attempt was significantly associated with reattempts in men (hazard ratio [HR] 2.49, 95% confidence interval [CI] 1.21–5.25). Substance‐related disorders (HR 3.65, 95% CI 1.16–7.9.60), drinking alcohol less than once per month (HR 0.42, 95% CI 0.17–0.88), previous suicide attempts (HR 2.28, 95% CI 1.40–3.87), and taking a drug overdose for the first suicide attempt (HR 1.82, 95% CI 1.14–3.01) were significantly associated with reattempts in women. Conclusion Our data highlight the importance of visits to a psychiatrist a short time before the first suicide attempt in men and substance‐related disorder, previous suicide attempts, and drug overdose in the first suicide attempt in women as predictive factors for future suicide reattempts.

Implementations of an evidence‐based assertive case management intervention for suicide attempters: Post‐ACTION‐J Study (PACS)

“…13 The secondary analysis also elucidated the importance of visits to a psychiatrist a short time before the first suicide attempt in men and in women with substance-related disorder, previous suicide attempts, and drug overdose in the first suicide attempt as predictive factors for future suicide reattempts. 14 The results of the present study indicated successful implementation of the assertive case management intervention program in a real-world clinical setting. The proportion of suicide attempters in this study who completed the 6-month assertive case management intervention was 72.2%.…”

“…Subsequent secondary analyses of ACTION‐J data also revealed that assertive case management helped prevent suicide reattempts among patients with comorbid DSM‐IV‐TR Axis I and II disorders 11 and those with a history of self‐poisoning, 12 and reduced the overall incidence of self‐harm 13 . The secondary analysis also elucidated the importance of visits to a psychiatrist a short time before the first suicide attempt in men and in women with substance‐related disorder, previous suicide attempts, and drug overdose in the first suicide attempt as predictive factors for future suicide reattempts 14 …”

“… 13 The secondary analysis also elucidated the importance of visits to a psychiatrist a short time before the first suicide attempt in men and in women with substance‐related disorder, previous suicide attempts, and drug overdose in the first suicide attempt as predictive factors for future suicide reattempts. 14 …”