Risk of suicide attempt repetition after an index attempt: A systematic review and meta-analysis
Open accessAbstract
OBJECTIVES: To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition. METHODS: This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022. RESULTS: A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01. CONCLUSION: One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives.
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The period after a suicide attempt is characterised by high vulnerability and elevated risk of relapse.
“The proposed protocol translates the available evidence into a manualised and replicable intervention that can be integrated into routine care after a suicide attempt, a period characterised by high vulnerability and elevated risk of relapse [80].”
From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [80]
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Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol
Comendador, L., Palao, D. J., Sanz, A., Andreo-Jover, J., Baca-García, E., Barrigón, M. L., Bobes-Bascarán, M. T., Botí, M. Á., Diaz-Marsá, M., Elices, M., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15083124 · Cited by 2 · see citing works
Self-citation
- Authors
- de la Torre-Luque, A., Pemau, A., Ayad-Ahmed, W., Borges, G., Fernandez-Sevillano, J., Garrido-Torres, N., Garrido-Sanchez, L., Garriga, M., Gonzalez-Ortega, I., Gonzalez-Pinto, A., Grande, I., Guinovart, M., Hernandez-Calle, D., Jimenez-Treviño, L., Lopez-Sola, C., Mediavilla, R., Perez-Aranda, A., Ruiz-Veguilla, M., Seijo-Zazo, E., Toll, A., Perez-Sola, V., & Ayuso-Mateos, J. L.
- Affiliations
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- Hospital Universitario Virgen del Rocío (ES)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Universitat Autònoma de Barcelona (ES)
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2023-03
- Volume
- 81
- Pages
- 51-56
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W4317726052
- Cited by
- 89
- References
- 42
- Citations by year
- 2026: 30 · 2025: 32 · 2024: 19 · 2023: 8
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- General Hospital Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by-nc-nd)
- Communities in ADDI (University of the Basque Country) (submittedVersion, cc-by-nc-nd)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion, cc-by-nc-nd)
- Hispana (submittedVersion, cc-by-nc-nd)
- idUS (Universidad de Sevilla) (submittedVersion, cc-by-nc-nd)
- Biblos-e Archivo (Universidad Autónoma de Madrid) (submittedVersion, public-domain)
- Funders
- Generalitat de Catalunya
- Instituto de Salud Carlos III (PI19/00236, PI19/00954, PI16/00187, PI19/00941, PI19/01027, PI19/00569, PI19/01256, PI20/00229, PI19/00685, PI19/01484)
- European Regional Development Fund
- Gobierno del Principado de Asturias (2017SGR1365, 2017SGR134, PCTI-2018-2022 IDI/2018/235)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- suicide attempts, risk factors, mental illness, suicide prevention programs, psychotherapy, female sex
- MeSH terms
- Female, Humans, Male, Psychotherapy, Risk Factors, Suicide, Attempted
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