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Sex Differences in Clinical Predictors of Suicidal Acts After Major Depression: A Prospective Study
Open accessAbstract
Objective: Whether sex differences exist in clinical risk factors associated with suicidal behavior is unknown. The authors postulated that among men with a major depressive episode, aggression, hostility, and history of substance misuse increase risk for future suicidal behavior, while depressive symptoms, childhood history of abuse, fewer reasons for living, and borderline personality disorder do so in depressed women. Method: Patients with DSM-III-R major depression or bipolar disorder seeking treatment for a major depressive episode (N=314) were followed for 2 years. Putative predictors were tested with Cox proportional hazards regression analysis. Results: During follow-up, 16.6% of the patients attempted or committed suicide. Family history of suicidal acts, past drug use, cigarette smoking, borderline personality disorder, and early parental separation each more than tripled the risk of future suicidal acts in men. For women, the risk for future suicidal acts was sixfold greater for prior suicide attempters; each past attempt increased future risk threefold. Suicidal ideation, lethality of past attempts, hostility, subjective depressive symptoms, fewer reasons for living, comorbid borderline personality disorder, and cigarette smoking also increased the risk of future suicidal acts for women. Conclusions: These findings suggest that the importance of risk factors for suicidal acts differs in depressed men and women. This knowledge may improve suicide risk evaluation and guide future research on suicide assessment and prevention.
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“In the context of NLP for voice recognition, the relevance of sex differences is evident in applications such as the prediction of suicidal behaviour83, especially considering the reported inconsistent and incomplete responses by popular conversational agents (Apple, Samsung, Microsoft) to suicidal ideation84.”
From Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare (2020) · cites this paper as [83]
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Metadata
- Authors
- Oquendo, M. A., Bongiovi-Garcia, M. E., Galfalvy, H., Goldberg, P. H., Grunebaum, M. F., Burke, A. K., & Mann, J. J.
- Affiliations
- New York State Psychiatric Institute (US)
- Venue
- American Journal of Psychiatry
- Published
- 2007-01
- Volume
- 164
- Issue
- 1
- Pages
- 134-141
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3785095
- OpenAlex
- W1989884455
- Cited by
- 249
- References
- 51
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 3 · 2022: 11 · 2021: 11 · 2020: 13 · 2019: 6 · 2018: 15 · 2017: 11 · 2016: 21 · 2015: 10 · 2014: 22 · 2013: 17 · 2012: 12
- FWCI
- 23.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Foundation for Suicide Prevention
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- National Alliance for Research on Schizophrenia and Depression
- H. Lundbeck A/S
- National Institute on Alcohol Abuse and Alcoholism
- National Institute of Mental Health (MH 62185, R01MH059710, MH48514, R01MH048514, MH 59710, P50MH062185)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- sex differences, suicidal behavior, major depressive disorder, suicide risk factors, suicide attempts, borderline personality disorder, childhood abuse, parental separation, cigarette smoking, substance abuse, hostility, reasons for living, suicidal ideation, bipolar disorder, suicide prevention
- MeSH terms
- Suicide Prevention, Adolescent, Adult, Aged, Borderline Personality Disorder, Child, Child Abuse, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Smoking, Suicide, Suicide, Attempted, Comorbidity, Diagnosis, Dual (Psychiatry), Substance-Related Disorders
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