Development of Reasons for Living and Dying with Suicide Attempters: A 2-Year Follow-Up Study

Gysin-Maillart, Anja Carolyn (24 September 2022). Development of Reasons for Living and Dying with Suicide Attempters: A 2-Year Follow-Up Study (Unpublished). In: ESSSB19th. Copenhagen.

Introduction: Clinical interventions for patients after a suicide attempt may focus on Reasons for Living (RFL) and/or Reasons for Dying (RFD). Aim: We examined the clinical implications of working with RFL and RFD of patients attending the Attempted Suicide Short Intervention Program (ASSIP), in comparison to a control group. Methods: In this secondary analysis of a 2-year randomized controlled study, the longitudinal development of RFL und RFD was examined. Participants (55% female; mean age of 36) with a history of suicide attempts therefore completed the Suicide Status Form II at baseline, 6-, 12-, 18-, and 24-months follow-up. Results: Differences in the longitudinal development of RFL and RFD were confirmed. The number of RFL did not change over time or between groups. In contrast, RFD decreased significantly over the 24-month period with a greater decrease in the ASSIP group (t1: 2.32 to t5: 0.51) compared to the control group (t1: 1.90 to t5: 1.04) (b=-0.02; p=.004). Furthermore, we identified three subgroups in the longitudinal development of RFD: a decreasing (n=77), a steady high (n=17) and a trajectory group with first increasing and then decreasing RFD (n=26). The proportion of ASSP patients was highest in the descending and lowest in the constant high group. Associations between RFD and suicidal ideation were found longitudinally (t1: p = .031 to t5: p < .000; beta between .193 and .539) and for suicidal behavior (t1: p = .051; OR = 1.25 to t5: p = .001, OR = 1.40). No associations were found for RFL. Patients in the steady high group were characterized by higher levels of suicidal ideation and more suicide reattempts throughout the 24-month period. Conclusion: The relevance of RFL as a protective factor was not confirmed. The results confirm the importance of RFD in the suicide process and show that patients whose RFD did not decrease over a long period of time are at particularly high risk for suicidal ideation and behavior. The number of RFD can be reduced over a 24-month period by brief interventions such as ASSIP. Clinical interventions should focus more on RFD, its aetiology, and maintenance.

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