A comprehensive study of medically serious suicide attempts in France: incidence and associated factors

Abstract

Aims People who make medically serious suicide attempts (MSSAs) share a number of features with those who die by suicide, and are at a high risk of suicide themselves. Studies to date have mostly focused on clinical samples of MSSAs. An epidemiological examination at a national level can help to identify risk profiles and pathways of care in this population. Methods We explored the French nationwide hospital discharge database (Programme de Médicalisation des Systèmes d'Information, PMSI) to identify any MSSA taking place between 2012 and 2019. Relevant demographic and medical information was collected about the first MSSA of each attempter. Data from 2010 and 2011 were used to verify the absence of prior attempts. Results First occurrences of MSSAs amounted to 81 959 cases over 8 years, with a mean age of 45.8 years, and 53.6% women. Incidence was higher in women (18.1 v. 17.3 per 1 00 000). The most common suicide method was deliberate self-poisoning (64.9% of cases). In comparison, violent methods associated higher mortality and comorbidity and were more frequent in men. The most common mental disorders were mood disorders (55.6%) and substance use disorders (46.2%). A minority of MSSA survivors were hospitalised in psychiatry (32.5%), mostly women. Conclusions MSSAs are frequent and easy to identify. There is a need to reinforce the continuity of psychiatric care for this population given the high risk of subsequent suicide, and the low rates of psychiatric hospitalisation after an MSSA even if violent methods are used. Specific care targeting this population could reduce treatment gaps.

Trends in medically serious suicide attempts before and after the COVID-19: a four-year retrospective analysis (2018-2022)

“…This result can be explained because MSSA can be studied as a subgroup, which differs from SA, not only because of the high lethality but also in view of the differential sociodemographic characteristics (36-38). Moreover, these data agree with Corbé et al 27 , who found that women represent half of MSSA cases out of a total sample of 81,959. Previous SA is the only predictive factor of suicide found (38), with Ammerman et al 33 stressing the need to implement suicidal risk screening in order to identify those who are at risk of suicide.…”

“…Concerning age, our data concurred with Corbé et al 27 who found a higher number of caseloads represented in the age group from 25-55 years old (27). Despite that, the literature reported an increase in SA in the elderly during the COVID period, associated with more vulnerability, lower economic inputs, and isolation (33,34).…”

“…MSSA patients needing admission to an Intensive Care Unit for treatment (hereinafter, MSSA-ICU subgroup), will be compared to those needing other types of treatment. According to the evidence, the number of admissions during the COVID period is expected to be positively correlated both to the number of MSSA and MSSA-ICU compared to the pre-COVID period (1,(26)(27)(28)(29). However, the number of MSSA during the COVID period is expected to be inversely correlated to the number of hospitalizations for COVID during that period.…”

Suicide Attempt Violence: Gender Differences, Diagnosis and Psychiatric Care Seeking in Mexico City

“…Regarding the methods of suicide, we uncovered statistically significant differences in terms of gender; men used methods that are more violent, while women used poisoning more frequently. This is in line with the data reported in France, where deliberate poisoning was more frequent in women and men who used methods related to a high likelihood of death [ 24 ]. In that study, the most frequent diagnoses were substance use and mood disorders.…”