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Risk factors for suicide reattempt: a systematic review and meta-analysis
- Andres Pemau, Carolina Marin-Martin, Marina Diaz-Marsa, Alejandro de la Torre-Luque, Wala Ayad-Ahmed, Ana Gonzalez-Pinto, Nathalia Garrido-Torres, Lucia Garrido-Sanchez, Natalia Roberto, Purificación Lopez-Peña, Lorea Mar-Barrutia, Iria Grande, Marti Guinovart, Daniel Hernandez-Calle, Luis Jimenez-Treviño, Clara Lopez-Sola, Roberto Mediavilla, Adrian Perez-Aranda, Miguel Ruiz-Veguilla, Elisa Seijo-Zazo, Alba Toll, Matilde Elices, Victor Perez-Sola, Jose Luis Ayuso-Mateos, the SURVIVE Consortium
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 16 April 2024, pp. 1-8
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Background
Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor.
MethodsThis systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury).
ResultsThe initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt.
ConclusionMost of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior
- Ángela Velasco, Julia Rodríguez-Revuelta, Emilie Olié, Iciar Abad, Abel Fernández-Peláez, Aurélie Cazals, Sébastien Guillaume, Lorena de la Fuente-Tomás, Luis Jiménez-Treviño, Laura Gutiérrez, Paz García-Portilla, Julio Bobes, Philippe Courtet, Pilar A. Sáiz
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- Journal:
- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 17 February 2020, e14
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- Article
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- Open access
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Background.
Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.
Methods.We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).
Results.Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266–2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).
Conclusions.Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.