Interaction between prospective risk factors in the prediction of suicide risk

Abstract

Background: To meet the goal of preventing suicide the most important thing is to know the risk factors of suicidal behavior and understand their interaction. Aims: The current study aims to evaluate prospective predictors and the interaction between factors for suicide and suicide re-attempts in high-risk, suicidal patients during a 24 month prospective follow-up period. Methods: A multicenter prospective cohort study was designed to compare data obtained from 324 patients admitted to the emergency department for current suicidal ideation or a recent suicide attempt. Participants were clinically evaluated at baseline and follow-up every 6 months to assess any unfavorable events (suicide or a suicide attempt). To estimate the rate of unfavorable events, the Kaplan–Meier method was used and Cox Proportional Hazards Regression Model was employed to examine predictors of suicide and suicide reattempt. Results: The incidence of a new suicide attempt was 26,000 events/100,000 persons-years. The incidence of death by suicide was 1110 events/100,000 person-year. The most reliable predictors of unfavorable events were being women, previous suicide attempts, younger age, and childhood sexual abuse. Findings revealed an interaction between childhood sexual abuse and low psychosocial functioning that increased the risk of an unfavorable event. Conclusion: The risk of suicide re-attempts and suicide in the current 2-year follow-up was high. There was an interaction between low psychosocial functioning and childhood sexual abuse. This evidence should be taken into account for the evaluation and planning of preventive strategies.