After a suicide attempt, reattempt risk is concentrated in the first year, yet how post-attempt non-suicidal self-injury (NSSI) patterns relate to the timing of reattempts remains unclear. Hazard-based models can quantify this association.

To evaluate whether NSSI pattern membership predicts time to suicide reattempt over 12 months in a multivariable Cox model.

Adults with a recent suicide attempt (n=685) were assessed ≤15 days post-attempt and followed for 12 months. NSSI pattern (reference=NN: No→No) was coded as Onset (No→Yes), Remission (Yes→No), or Persistence (Yes→Yes). The initial covariates were age, sex, number of prior attempts, BIS-11 subscales, ACSS-FAD, MINI diagnoses (count), BSI-GSI, reasons for ideation, and NSSI pattern. Backward elimination by Akaike’s Information Criterion (AIC) yielded the final model. We report hazard ratios (HR) with 95% CIs.

The final Cox model (Figure 1) retained age, number of prior attempts, reasons for ideation (reference=External), and NSSI pattern (AIC=833.7; χ²(7)=22.26, p<.002; concordance=.632). Older age was associated with lower hazard (HR=0.98, 95% CI [0.96, 0.99]); more prior attempts with higher hazard (HR=1.02, 95% CI [1.01, 1.04]). Relative to NN, Remission (HR=0.56, 95% CI [0.32, 0.96]) and Persistence (HR=0.58, 95% CI [0.35, 0.96]) were associated with reduced 12-month hazard; Onset did not differ significantly.Image 1:

After a suicide attempt, NSSI pattern membership provides prognostic information beyond age and attempt history. Compared with NN, Remission and Persistence were linked to lower 12-month reattempt hazard, whereas Onset was not. Tracking NSSI patterns may refine post-discharge risk stratification and follow-up planning.

None Declared