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Psychiatric comorbidity profiles among suicidal attempters: A cohort study

Published online by Cambridge University Press:  19 July 2023

Y. Sanchez-Carro
Affiliation:
1Universidad Autonoma de Madrid 2Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII)
M. Diaz-Marsa
Affiliation:
3CIBERSAM ISCIII 4Universidad Complutense de Madrid 5Health Research Institute, Hospital Clínico San Carlos (IdISSC)
V. Fernandez-Rodrigues
Affiliation:
5Health Research Institute, Hospital Clínico San Carlos (IdISSC) 6Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology
W. Ayad-Ahmed
Affiliation:
5Health Research Institute, Hospital Clínico San Carlos (IdISSC)
A. Pemau
Affiliation:
6Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology
I. Perez-Diaz
Affiliation:
1Universidad Autonoma de Madrid
A. Galvez-Merlin
Affiliation:
7Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid 8Health Research Institute, Hospital Clínico San Carlos (IdISSC)
P. de la Higuera-Gonzalez*
Affiliation:
5Health Research Institute, Hospital Clínico San Carlos (IdISSC) 6Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology
V. Perez-Sola
Affiliation:
9Institut Hospital del Mar d’Investigacions Mediques (IMIM) 10Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII), Madrid, Spain
P. Saiz
Affiliation:
2Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII) 11Universidad de Oviedo, Oviedo
I. Grande
Affiliation:
12Bipolar and Depressive Disorders Unit, Hospital Clinic 13Institute of Neurosciences, University of Barcelona 14August Pi i Sunyer Biomedical Research Institute (IDIBAPS) 15Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII), Barcelona
A. Cebria
Affiliation:
16Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII) 17Corporacio Sanitaria Parc Tauli, Sabadell
J. Andreo-Jover
Affiliation:
1Universidad Autonoma de Madrid 18Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid
P. Lopez-Peña
Affiliation:
2Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII) 18Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid
M. Ruiz-Veguilla
Affiliation:
19Hospital Universitario Virgen del Rocio 20Biomedical Research Networking Consortium for Mental Health (CIBERSAM ISCIII), Sevilla
A. de la Torre-Luque
Affiliation:
7Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid 21Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Madrid, Spain
*
*Corresponding author.

Abstract

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Introduction

More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.

Objectives

The aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.

Methods

A sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.

Results

Two classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).

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Conclusions

We found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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