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Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?

Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depr...

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Autores principales: Aaltonen, Kari I., Rosenström, Tom, Jylhä, Pekka, Holma, Irina, Holma, Mikael, Pallaskorpi, Sanna, Riihimäki, Kirsi, Suominen, Kirsi, Vuorilehto, Maria, Isometsä, Erkki T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725715/
https://www.ncbi.nlm.nih.gov/pubmed/33324247
http://dx.doi.org/10.3389/fpsyt.2020.547791
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author Aaltonen, Kari I.
Rosenström, Tom
Jylhä, Pekka
Holma, Irina
Holma, Mikael
Pallaskorpi, Sanna
Riihimäki, Kirsi
Suominen, Kirsi
Vuorilehto, Maria
Isometsä, Erkki T.
author_facet Aaltonen, Kari I.
Rosenström, Tom
Jylhä, Pekka
Holma, Irina
Holma, Mikael
Pallaskorpi, Sanna
Riihimäki, Kirsi
Suominen, Kirsi
Vuorilehto, Maria
Isometsä, Erkki T.
author_sort Aaltonen, Kari I.
collection PubMed
description Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself.
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spelling pubmed-77257152020-12-14 Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt? Aaltonen, Kari I. Rosenström, Tom Jylhä, Pekka Holma, Irina Holma, Mikael Pallaskorpi, Sanna Riihimäki, Kirsi Suominen, Kirsi Vuorilehto, Maria Isometsä, Erkki T. Front Psychiatry Psychiatry Background: Preceding suicide attempts strongly predict future suicidal acts. However, whether attempting suicide per se increases the risk remains undetermined. We longitudinally investigated among patients with mood disorders whether after a suicide attempt future attempts occur during milder depressive states, indicating a possible lowered threshold for acting. Methods: We used 5-year follow-up data from 581 patients of the Jorvi Bipolar Study, Vantaa Depression Study, and Vantaa Primary Care Depression Study cohorts. Lifetime suicide attempts were investigated at baseline and during the follow-up. At follow-up interviews, life-chart data on the course of the mood disorder were generated and suicide attempts timed. By using individual-level data and multilevel modeling, we investigated at each incident attempt the association between the lifetime ordinal number of the attempt and the major depressive episode (MDE) status (full MDE, partial remission, or remission). Results: A total of 197 suicide attempts occurred among 90 patients, most during MDEs. When the dependencies between observations and individual liabilities were modeled, no association was found between the number of past suicide attempts at the time of each attempt and partial remissions. No association between adjusted inter-suicide attempt times and the number of past attempts emerged during follow-up. No indication for direct risk-increasing effects was found. Conclusion: Among mood disorder patients, repeated suicide attempts do not tend to occur during milder depressive states than in the preceding attempts. Previous suicide attempts may indicate underlying diathesis, future risk being principally set by the course of the disorder itself. Frontiers Media S.A. 2020-11-26 /pmc/articles/PMC7725715/ /pubmed/33324247 http://dx.doi.org/10.3389/fpsyt.2020.547791 Text en Copyright © 2020 Aaltonen, Rosenström, Jylhä, Holma, Holma, Pallaskorpi, Riihimäki, Suominen, Vuorilehto and Isometsä. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Aaltonen, Kari I.
Rosenström, Tom
Jylhä, Pekka
Holma, Irina
Holma, Mikael
Pallaskorpi, Sanna
Riihimäki, Kirsi
Suominen, Kirsi
Vuorilehto, Maria
Isometsä, Erkki T.
Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title_full Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title_fullStr Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title_full_unstemmed Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title_short Do Suicide Attempts of Mood Disorder Patients Directly Increase the Risk for a Reattempt?
title_sort do suicide attempts of mood disorder patients directly increase the risk for a reattempt?
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725715/
https://www.ncbi.nlm.nih.gov/pubmed/33324247
http://dx.doi.org/10.3389/fpsyt.2020.547791
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