Suicide and All-Cause Mortality Within 1 Year After a Suicide Attempt in the VigilanS Cohort

Alice Demesmaeker, MD, MSC; Ali Amad, MD, PhD; Emmanuel Chazard, MD, PhD; Anne-Laure Demarty; Honorine Schlienger, MD; Emma Lehmann, MD; Christophe Debien, MD; Vincent Jardon, MD; Karim Bounebache; Gregoire Rey, MD; Guillaume Vaiva, MD, PhD

J Clin Psychiatry 2023;84(6):22m14520

ABSTRACT

Objective: Obtaining better knowledge on the outcomes of patients who attempt suicide is crucial for suicide prevention. The aim of our study was to determine the causes of death 1 year after a suicide attempt (SA) in the VigilanS program, mortality rates, and risk factors associated with any cause of death and suicide.

Methods: A prospective cohort of 7,406 people who had attempted suicide between January 1, 2017, and December 31, 2018, was included in the study. The vital status of each participant was sought, and the cause of death was established through a phone call to their general practitioner or psychiatrist. Second, the relationship between sociodemographic and clinical factors and death by suicide within 1 year of an SA was assessed using a multivariable Cox model.

Results: At 1 year, 125 (1.7%) participants had died, 77 of whom died by suicide. Half of the deaths occurred within the first 4 months after an SA. Hanging (20.3%; 24/125) and self-poisoning (19.5%; 23/125) were the methods the most often used for suicide. We demonstrated that male sex (HR = 1.79 [1.13–2.82], P = .01) and being 45 years of age or older (between 45 and 64 years old, HR = 2.08 [1.21–3.56], P < .01; 65 years or older, HR = 5.36 [2.72–10.54], P < .01) were associated with a higher risk of death by suicide 1 year after an SA and that being younger than 25 years was associated with a lower risk (HR = 0.22 [0.07–0.76], P = .02).

Conclusions: One out of 100 people who attempted suicide died by suicide within 1 year after an SA. Greater vigilance is required in the first months following an SA, especially for males older than 45 years.

Trial Registration: ClinicalTrials.gov identifier: NCT03134885

J Clin Psychiatry 2023;84(6):22m14520

Author affiliations are listed at the end of this article.

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