Risk Factors for Reattempt and Suicide Within 6 Months After an Attempt in the French ALGOS Cohort: A Survival Tree Analysis

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Overview

Understanding risk factors for suicidal behavior is crucial for the development of effective prevention plans. Do anxiety disorders or alcohol use disorder play a role? Learn more in this CME activity.

Abstract

Objective: Understanding the cumulative effect of several risk factors involved in suicidal behavior is crucial for the development of effective prevention plans. The objective of this study is to provide clinicians with a simple predictive model of the risk of suicide attempts and suicide within 6 months after suicide attempt.

Methods: A prospective observational cohort of 972 subjects, included from January 26, 2010, to February 28, 2013, was used to perform a survival tree analysis with all sociodemographic and clinical variables available at inclusion. The results of the decision tree were then used to define a simple predictive algorithm for clinicians.

Results: The results of survival tree analysis highlighted 3 subgroups of patients with an increased risk of suicide attempt or death by suicide within 6 months after suicide attempt: patients with alcohol use disorder and a previous suicide attempt with acute alcohol use (risk ratio [RR] = 2.92; 95% CI, 2.08 to 4.10), patients with anxiety disorders (RR = 0.98; 95% CI, 0.69 to 1.39), and patients with a history of more than 2 suicide attempts in the past 3 years (RR = 2.11; 95% CI, 1.25 to 3.54). The good prognosis group comprised all other patients.

Conclusions: By using a data-driven method, this study identified 4 clinical factors interacting together to reduce or increase the risk of recidivism. These combinations of risk factors allow for a better evaluation of a subject’s suicide risk in clinical practice.

Trial Registration: ClinicalTrials.gov identifier: NCT01123174

To cite: Demesmaeker A, Chazard E, Vaiva G, et al. Risk factors for reattempt and suicide within 6 months after an attempt in the French ALGOS cohort: a survival tree analysis. J Clin Psychiatry. 2021;82(1):20m13589.

https://doi.org/10.4088/JCP.20m13589


Read the whole article at JCP here: 
Risk Factors for Reattempt and Suicide Within 6 Months After an Attempt in the French ALGOS Cohort: A Survival Tree Analysis

© Copyright 2021 Physicians Postgraduate Press, Inc.

Target Audience

Psychiatrists

Learning Objectives

After studying this article, you should be able to:

  • Evaluate patients who have attempted suicide for clinical factors that interact to affect the risk of recidivism
Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
02/18/2021
Activity expires: 
02/28/2023
Cost:
$10.00
Rating: 
0

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results. To obtain credit, read the article, correctly answer the questions in the Posttest, and complete the Evaluation.

CME Objective

After studying this article, you should be able to:

  • Evaluate patients who have attempted suicide for clinical factors that interact to affect the risk of recidivism

Statement of Need and Purpose

Individuals who have attempted suicide in the past are especially at risk for attempting suicide in the future, especially in the months immediately following the initial attempt. Clinicians thus need reliable tools that will allow them to identify risk factors for suicide attempt among their patients. To best assess risk, clinicians need to understand not only the individual risk factors for suicide reattempt but also the interplay of these factors. A statistical approach such as survival tree analysis that can discern associations between risk factors can allow for the identification of specific groups of individuals at especially high risk for suicide reattempt.

Release, Expiration, and Review Dates

This educational activity was published in February 2021 and is eligible for AMA PRA Category 1 Credit™ through February 28, 2023. The latest review of this material was January 2021.

Disclosure of off-label usage

The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.

Funding/support

The authors of this study received no funds for this research. The authors acknowledge the support of the French World Health Organization Collaborating Center in Mental Health and the French “Groupement d’Etude et de Prevention du Suicide” (GEPS).

Role of the sponsor

The providers of support had no role in the conduct of this research and on the composition of this report.

Faculty Affiliation

Alice Demesmaeker, MD, MSc*
University of Lille, Inserm, CHU Lille, U1172 – LilNCog—Lille Neuroscience & Cognition, Lille, France

Emmanuel Chazard, MD, PhD
University of Lille, CHU Lille, ULR 2694, CERIM, Public Health Department, Lille, France

Guillaume Vaiva, MD, PhD
University of Lille, Inserm, CHU Lille, U1172 – LilNCog—Lille Neuroscience & Cognition, Lille, France, and Centre National de Ressources et de Résilience (CN2R), Lille, France

Ali Amad, MD, PhD
University of Lille, Inserm, CHU Lille, U1172 – LilNCog—Lille Neuroscience & Cognition, Lille, France

*Corresponding author: Alice Demesmaeker, MD, MSc, Hôpital Fontan, CHU de Lille, F-59037, Lille Cedex, France (alice.demesmaeker@chru-lille.fr).

Financial Disclosure

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; and has been a member of the Independent Data Safety and Monitoring Committee for Janssen. No member of the CME Institute staff reported any relevant personal financial relationships.

Drs DemesmaekerChazardVaiva, and Amad have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation

Price

Cost:
$10.00
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