Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
J Affect Disord. 2020 Jun 15;271:328-335. doi: 10.1016/j.jad.2020.04.006. Epub 2020 Apr 18.
This study is aimed to investigate the association between clinical, metabolic, inflammatory and environmental (photoperiod defined as daily sunlight exposure) parameters and suicide re-attempts after the index suicide attempt. Possible predictors of suicide re-attempts were also explored.
Overall, 432 subjects with suicide attempts, of which 79 relapsed within the following six months were included in this prospective study. We adopted the Joiner's definition of suicide lethality, as "the acquired ability to enact lethal self-injury". The Cox regression was used to test the association between the mentioned variables and Kaplan-Meier plots showed the trend of suicide re-attempts.
Among participants, 30.8% committed a high-lethality suicide attempt. Cox regression confirmed the association between lifetime suicide attempts and number of suicide attempts in the study time-frame and suicide-reattempts. The longer photoperiod (Spring/Summer) was associated with suicide re-attempts, particularly patients with admission in June/July for the index event. Total cholesterol (TC), low-density lipo-protein cholesterol and c-reactive protein serum levels were significantly associated with suicide re-attempts but Cox regression confirmed only the association between lower TC serum levels and suicide re-attempt.
Patients' seasonal environment, psychological factors, presence of acute life-events fostering the suicidal crisis and detailed medical history have been not investigated. Findings were derived from a single psychiatric unit.
Lifetime suicide attempts, higher number of previous suicide attempts, lower total cholesterol levels, and suicide attempt during longer photoperiod were significant predictors of suicide re-attempts. Further studies are needed in order to better characterize single- vs. multiple suicide attempter's profiles.
本研究旨在探讨临床、代谢、炎症和环境（以每日光照时间定义的光周期）参数与首次自杀尝试后的自杀再尝试之间的关联。还探讨了自杀再尝试的可能预测因素。
本前瞻性研究共纳入 432 例自杀未遂者，其中 79 例在接下来的 6 个月内复发。我们采用了乔伊纳（Joiner）对自杀致命性的定义，即“实施致命性自我伤害的习得能力”。Cox 回归用于检验上述变量与自杀再尝试之间的关联，Kaplan-Meier 图显示了自杀再尝试的趋势。
在参与者中，30.8%的人进行了高致命性自杀尝试。Cox 回归证实了一生中自杀尝试次数和研究期间自杀尝试次数与自杀再尝试之间的关联。较长的光周期（春季/夏季）与自杀再尝试相关，尤其是在 6 月/7 月入院的患者。总胆固醇（TC）、低密度脂蛋白胆固醇和 C 反应蛋白血清水平与自杀再尝试显著相关，但 Cox 回归仅证实了 TC 血清水平较低与自杀再尝试之间的关联。
未调查患者的季节性环境、心理因素、急性生活事件的存在对自杀危机的影响以及详细的病史。研究结果来源于单一的精神科病房。
一生中自杀尝试次数、既往自杀尝试次数较多、总胆固醇水平较低以及光周期较长时发生自杀尝试是自杀再尝试的显著预测因素。需要进一步的研究以更好地描述单次和多次自杀尝试者的特征。
