Sex-specific survival trajectories in frequent suicide reattempters: a 5-year prospective cohort study

Le résumé fourni par la source

Background Frequent repeaters (≥ 5 suicide attempts) remain poorly characterized despite their high vulnerability. We examined sex differences and 5-year mortality in this subgroup. Methods This longitudinal study used the MCOSUL cohort (Lleida, Spain). Patients with ≥5 prior attempts and an index episode between 2009 and 2022 were followed for 5 years or until death. Baseline variables were compared by sex. Survival was analyzed using Kaplan–Meier curves (log-rank test) and a Cox model adjusted for age, sex, and somatic lethality of the index attempt. Results The sample included 175 patients (71.8% women; median age = 43 years [IQR 33–51]). Women were more often employed (19%vs 6%), while men had higher unemployment (44%vs 26%) and alcohol use (58%vs 38%) (all p < 0.05). Eleven deaths (6.3%) occurred over 5 years, including 5 suicides (2.9%). Cumulative mortality was higher in men (12%vs 4%; p = 0.079). Kaplan–Meier curves showed significantly lower survival among men (log-rank p = 0.041). This pattern was confirmed in the multivariable Cox model, where female sex was associated with reduced mortality risk (HR = 0.29, 95% CI 0.09–0.98, p = 0.036). High somaticlethality of the index attempt showed a nonsignificant trend toward increased risk (HR = 2.97, 95% CI 0.86–10.3, p = 0.086). Conclusions Among high-frequency attempters, men show poorer 5-year survival, while female sex independently predicts lower mortality risk. Prioritizing follow-up in men and in patients using somatic lethal methods may enhance preventive strategies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.