Risk of suicide attempt repetition after an index attempt: A systematic review and meta-analysis
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Date
2023-03Author
De la Torre Luque, Alejandro
Pernau, Andrés
Ayad-Ahamed, Wala
Borges, Guilherme
Fernández Sevillano, Jessica
Garrido Torres, Nathalia
Garrido Sánchez, Lucía
Garriga, Marina
González Ortega, Itxaso
Grande, Iria
Guinovart, Martí
Hernández Calle, Daniel
Jiménez Treviño, Luis
López Sola, Clara
Mediavilla, Roberto
Pérez Aranda, Adrián
Ruiz Veguilla, Miguel
Seijó Zazo, Elisa
Toll, Alba
Pérez Sola, Víctor
Ayuso Mateos, José Luis
SURVIVE Consortium
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General Hospital Psychiatry 81 : 51-56 (2023)
Abstract
Objectives
To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition.
Methods
This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022.
Results
A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01.
Conclusion
One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives.