Psychosocial stressors may be strongly associated with suicide attempts

Stressful life events are associated with a high proportion of suicide attempts. The aim of this study is to clarify the importance of psychosocial stressors in suicidal behaviour. A total of 258 suicide attempters seen at a general hospital emergency room, and 325 blood donors without suicide/psychiatric disorder history were recruited. Acute and chronic life events were assessed with the St. Paul Ramsey Life Experience Scale and Holmes and Rahe's Social Adjustment Scale, respectively. Lifelong adverse experiences were also assessed. After univariate analyses, the significant variables were introduced in a multivariate analysis (logistic regression). The logistic regression with a dependent variable (attempter versus control status) included psychosocial stressors (partner conflicts [odds ratio (OR) = 33.6] and other interpersonal conflicts [OR = 10.5], modification of life habits [OR = 14.6], and adult physical abuse [OR = 7.1]). Confounding factors with significant ORs were Cluster B traits [OR = 21.2]; and two protective factors, living with a partner [OR = 0.25] and currently working [OR = 0.06]. Psychosocial stressors and Cluster B traits appeared to be strongly associated with suicide attempter status. One limitation of the study is the lack of inclusion of psychiatric controls (psychiatric patients without history of suicide attempts). Another limitation is the difficulty of determining suicide intent. Finally, this study is mainly a replication of prior knowledge of psychosocial stressors, but compares their association strength (OR > 10) with the association strength of prior biological findings (OR = 1-2).