Risk Factors for First-Attempt Suicide Fatalities: Evidence From the MCOSUL Cohort.

Area of Science:

• Public Health
• Epidemiology
• Mental Health Research

Background:

• Suicide fatalities may differ based on whether the death resulted from a first-time or a subsequent suicide attempt.
• Understanding these distinctions is crucial for refining suicide prevention strategies.

Purpose of the Study:

• To compare sociodemographic, clinical, and method-related variables between individuals who died by suicide on their first attempt versus those with prior non-fatal attempts.
• To identify independent predictors of first-attempt suicide fatalities.

Main Methods:

• Cross-sectional analysis of the MCOSUL Cohort, a clinical registry of suicide attempt patients in Lleida, Spain (January 2009 - December 2022).
• Comparison of variables between first-attempt and repeat-attempt suicide fatalities.
• Multivariable logistic regression to identify predictors of first-attempt fatalities.

Main Results:

• Of 117 suicide deaths, 32.5% were first attempts and 67.5% were repeat attempts.
• Unemployment and recognized disability were less frequent in first-attempt fatalities, suggesting they are more common in repeat-attempt fatalities.
• No significant differences were observed in age, sex, alcohol use, psychiatric diagnosis, or fatal attempt method between the groups.

Conclusions:

• Unemployment and recognized disability characterize individuals who die by suicide after multiple attempts.
• This suggests a subgroup with a prolonged suicidal trajectory requiring sustained engagement and tailored prevention strategies.
• Findings highlight the need for targeted interventions for individuals with a history of non-fatal suicide attempts.