Clustering Suicide Attempters: Impulsive-Ambivalent, Well-Planned, or Frequent
Abstract
BACKGROUND: Attempts to predict suicidal behavior within high-risk populations have so far shown insufficient accuracy. Although several psychosocial and clinical features have been consistently associated with suicide attempts, investigations of latent structure in well-characterized populations of suicide attempters are lacking. METHODS: We analyzed a sample of 1,009 hospitalized suicide attempters that were recruited between 1999 and 2012. Eleven clinically relevant items related to the characteristics of suicidal behavior were submitted to a Hierarchical Ascendant Classification. Phenotypic profiles were compared between the resulting clusters. A decisional tree was constructed to facilitate the differentiation of individuals classified within the first 2 clusters. RESULTS: Most individuals were included in a cluster characterized by less lethal means and planning ("impulse-ambivalent"). A second cluster featured more carefully planned attempts ("well-planned"), more alcohol or drug use before the attempt, and more precautions to avoid interruptions. Finally, a small, third cluster included individuals reporting more attempts ("frequent"), more often serious or violent attempts, and an earlier age at first attempt. Differences across clusters by demographic and clinical characteristics were also found, particularly with the third cluster whose participants had experienced high levels of childhood abuse. CONCLUSIONS: Cluster analysis consistently supported 3 distinct clusters of individuals with specific features in their suicidal behaviors and phenotypic profiles that could help clinicians to better focus prevention strategies.
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Frequent hospitalizations, past suicide attempts, social isolation, and personality problems are recurring findings in suicidal individuals.
“These are recurring findings in suicidal individuals.22”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [22]
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- Authors
- Lopez-Castroman, J., Nogue, E., Guillaume, S., Picot, M. C., & Courtet, P.
- Affiliations
- Inserm (FR)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2016-03-29
- Volume
- 77
- Issue
- 06
- Pages
- e711-e718
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2320394680
- Cited by
- 38
- References
- 5
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 9 · 2017: 2 · 2016: 1
- FWCI
- 7.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- 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 › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- suicide attempts, suicide attempters, suicide planning, impulsivity, childhood abuse, alcohol and drug use, repeated suicide attempts, violent suicide attempts, suicide prevention, hospitalized patients
- MeSH terms
- Adult, Decision Trees, Female, Humans, Impulsive Behavior, Life Change Events, Male, Middle Aged, Personality Assessment, Psychometrics, Surveys and Questionnaires, Risk Factors, Suicide, Attempted, Cohort Studies, Cluster Analysis, Risk Assessment, Suicidal Ideation
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