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Characteristics of single vs. multiple suicide attempters among adolescents: a systematic review and meta-analysis

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Abstract

There might be differential characteristics between those who have attempted suicide once in their lifetime (single attempters) and those who have attempted suicide two or more times (multiple attempters). We aimed to identify the factors that differentiate single and multiple attempters in child and adolescents. This study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the review protocol was registered in PROSPERO. We conducted a systematic literature search in three databases to identify original studies exploring the characteristics of single attempters vs. multiple attempters among adolescents. We considered a wide range for the definition of adolescent, following most recent recommendations: 10–24 years. We carried out a meta-analysis. Fourteen studies were included in the systematic review and 13 in the meta-analysis with a total sample of with a total of 4286 participants. The factors statistically significantly associated with being a multiple attempter in the meta-analysis were: anxiety disorders, depression severity, alcohol abuse, substance abuse, aggressiveness, and hopelessness. Multiple attempters have a more severe clinical profile, with greater severity of symptoms. Knowledge of the risk factors associated with being a multiple attempter could help us to predict which patients are more likely to reattempt suicide and need further monitoring and a tailored treatment. Prevention programs tailored for the adolescent population, along with identification of early risk factors, could help to prevent suicidal behavior among this vulnerable population.

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Acknowledgements

The authors received grant support from the Instituto de Salud Carlos III (ISCIII JR22/00011), the Alicia Koplowitz Foundation, and the Spanish National Project (RTI2018-101857-B-I00).

Funding

The authors received grant support from Instituto de Salud Carlos III (CM19/00026) and the Alicia Koplowitz Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain

    Berta Ezquerra & Enrique Baca-García

  2. Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, Universidad of Zaragoza, Teruel, Spain

    Adrián Alacreu-Crespo

  3. Department of Child and Adolescent Psychiatry, Hospital 12 de Octubre, Madrid, Spain

    Inmaculada Peñuelas-Calvo & Enrique Baca-García

  4. Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain

    Inmaculada Peñuelas-Calvo & Enrique Baca-García

  5. Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Sofía Abascal-Peiró & Enrique Baca-García

  6. Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain

    Laura Jiménez-Muñoz & Alejandro Porras-Segovia

  7. Division of Psychiatry, Imperial College, London, UK

    Dasha Nicholls & Alejandro Porras-Segovia

  8. Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain

    Enrique Baca-García

  9. Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain

    Enrique Baca-García

  10. Universidad Católica del Maule, Talca, Chile

    Enrique Baca-García

  11. CIBERSAM, Madrid, Spain

    Enrique Baca-García

  12. Université de Nîmes, Nîmes, France

    Enrique Baca-García

  13. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

    Enrique Baca-García

Authors
  1. Berta Ezquerra
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  2. Adrián Alacreu-Crespo
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  3. Inmaculada Peñuelas-Calvo
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  4. Sofía Abascal-Peiró
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  5. Laura Jiménez-Muñoz
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  6. Dasha Nicholls
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  7. Enrique Baca-García
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  8. Alejandro Porras-Segovia
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Contributions

"I.P.C., S.A.P. and A.P.S. conceived and designed the study. S.A.P. and I.P.C. carried out the bibliographical search and the screening and selection of the reviewed studies. B.E. and I.P.C. mined the data. A.A.C. carried out the meta-analysis and contributed substantially to the drafting and revision of the manuscript. B.E., L.J.M. and A.P.S. wrote the manuscript. D.N. and E.B.G. supervised the work and contributed substantially to the drafting and revision of the manuscript."

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Correspondence to Inmaculada Peñuelas-Calvo or Alejandro Porras-Segovia.

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Ezquerra, B., Alacreu-Crespo, A., Peñuelas-Calvo, I. et al. Characteristics of single vs. multiple suicide attempters among adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry (2023). https://doi.org/10.1007/s00787-023-02260-2

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