Personality disorders and health problems distinguish suicide attempters from completers in a direct comparison

Lucas Giner, Hilario Blasco-Fontecilla, M. Mercedes Perez-Rodriguez, Rebeca Garcia-Nieto, Jose Giner, Julio A. Guija, Antonio Rico, Enrique Barrero, Maria Angeles Luna, Jose De Leon, Maria A. Oquendo, Enrique Baca-Garcia

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Background Whether suicide attempters and completers represent the same population evaluated at different points along a progression towards suicide death, overlapping populations, or completely different populations is a problem still unresolved. Methods 446 Adult suicide attempters and knowledgeable collateral informants for 190 adult suicide probands were interviewed. Sociodemographic and clinical data was collected for both groups using semi-structured interviews and structured assessments. Univariate analyses and logistic regression models were conducted to explore the similarities and differences between suicide attempters and completers. Results Univariate analyses yielded significant differences in sociodemographics, recent life events, impulsivity, suicide intent, and distribution of Axis I and II disorders. A logistic regression model aimed at distinguishing suicide completers from attempters properly classified 90% of subjects. The most significant variables that distinguished suicide from attempted suicide were the presence of narcissistic personality disorder (OR=21.4; 95% CI=6.8-67.7), health problems (OR=20.6; 95% CI=5.6-75.9), male sex (OR=9.6; 95% CI=4.42-20.9), and alcohol abuse (OR=5.5; 95% CI=2.3-14.2). Limitations Our study shares the limitations of studies comparing suicide attempters and completers, namely that information from attempters can be obtained from the subject himself, whereas the assessment of completers depends on information from close family or friends. Furthermore, different semi-structured instruments assessed Axis I and Axis II disorders in suicide attempters and completers. Finally, we have no data on inter-rater reliability data. Conclusions Suicide completers are more likely to be male and suffer from alcohol abuse, health problems (e.g. somatic illness), and narcissistic personality disorder. The findings emphasize the importance of implementing suicide prevention programs tailored to suicide attempters and completers.

Original languageEnglish
Pages (from-to)474-483
Number of pages10
JournalJournal of Affective Disorders
Volume151
Issue number2
DOIs
StatePublished - Nov 2013

Bibliographical note

Funding Information:
This article was supported by the National Alliance for Research on Schizophrenia and Affective Disorders (NARSAD) , the American Foundation of Suicide Prevention (AFSP, Young Investigator, 2006) , the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment , the Medical Research Service of the Veterans Affairs James J. Peters VAMC , the Department of Veterans Affairs NY/NJ (VISN3) Mental Illness Research, Education, and Clinical Center (MIRECC) , the Fondo de Investigacion Sanitaria (FIS) PI060092, the Fondo de Investigacion Sanitaria FIS RD06/0011/0016 , ETES ( PI07/90207 ), the Conchita Rabago Foundation , the Spanish Ministry of Health , the Instituto de Salud Carlos III , CIBERSAM (Intramural Project, P91B ; Rio Hortega CM08/00170 , CM10/00034 and SCO/3410/2004 ), and Fundacion Española de Psiquiatria (2005 and 2006) , and Consorcio para la excelencia de la investigación forense de Andalucia (CEIFA) (2007) .

Funding Information:
Dr. Oquendo receives royalties for use of the Columbia Suicide Severity Rating Scale and received financial compensation from Pfizer for the safety evaluation of a clinical facility, unrelated to this study. She received a grant from Eli Lilly to support a year's salary for a Lilly Suicide Scholar. She has received unrestricted educational grants and/or lecture fees from Astra-Zeneca, Bristol Myers Squibb, Eli Lilly, Janssen, Otsuko, Pfizer, Sanofi-Aventis, and Shire. Her family owns stock in Bristol Myers Squibb. Dr. Blasco-Fontecilla has received lecture fees from Eli Lilly and AB-Biotics. The remaining authors report no conflict of interest.

Keywords

  • Alcohol abuse
  • Attempted suicide
  • Impulsivity
  • Personality disorder
  • Suicide

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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