Factors associated with single versus multiple suicide attempts in depressive disorders

Leonardo Tondo, Ross J Baldessarini, Margherita Barbuti, Paola Colombini, Jules Angst, Jean-Michel Azorin, Charles L Bowden, Sergey Mosolov, Allan H Young, Eduard Vieta, Giulio Perugi

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)
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BACKGROUND: Many risk factors for suicidal behavior have been identified. Much less has been done to associate risk factors with recurrence of suicidal behavior.

METHODS: We compared prevalence of 30 potential risk factors among 8496 depressive patient-subjects from the BRIDGE consortium with no (NSA, n = 6267), one (1SA, n = 1123), or repeated (≥2) suicide attempts (RSA, n = 1106).

RESULTS: Prevalence of most factors ranked: RSA ≥ 1SA > NSA, with a notable opposite trend for the diagnosis of type II bipolar disorder (BD). Factors independently and significantly more present among RSA than 1SA subjects were: borderline personality, substance abuse, mood-switching with antidepressant treatment, female sex, and unsatisfactory response to antidepressant treatment. There also were notably strong associations of RSA with type I or probable BD and associated factors, including family history of BD, young onset, mixed and psychotic features.

LIMITATIONS: Potential effects of treatment on risk of suicidal acts could not be evaluated adequately, as well as associations between levels of suicidal behavior and eventual death by suicide.

CONCLUSIONS: In a large cohort of depressive patients, there were significant associations not only with suicidal behavior generally, but also with the intensity of suicide attempts.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalJournal of Affective Disorders
Early online date14 Aug 2020
Publication statusPublished - 1 Dec 2020


  • Bipolar disorder
  • Depressive episode
  • Suicide attempts


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