Effective Factors in Recurrent Deliberate Self-Poisoning Attempts

Abstract

Background: The most common suicide attempt (SA) is deliberate self-poisoning (DSP) in Iran. Although the proportion of fatal suicide by DSP is much lower compared to other methods, repeated suicide attempts (RSA) are very high. Objectives: This study aimed at determining the effective factors on RSA among patients referred due to DSP in west of Iran. Methods: All cases attempting DSP, who were referred to the only main poisoning treatment centre in the west of Iran, were assessed during year 2014. They were interviewed by psychologists in order to determine the number of SAs for each person individually, using data linkage. Data was analyzed by zero-truncated poisson regression. Results: During year 2014, of 1790 cases committed with DSP, 64 (3.5%) died because of the severity of poisoning. Among non-fatal DSP attempters, 1069 (61.94%) attempted suicide for the first time and 334 (19.34%) for the second time. In the multivariate model, age was an important predictor of RSA, so that the risk of RSA in 26 to 35 year-old age group was lower than in the 18-year-old age group (IRR 0.3, 95 % CI, 0.2 to 0.4 P = 0.001). Also, SA history was the first risk factor for RSA, so that individuals with SA history had higher RSA than individuals without SA history (IRR 3.1, 95 % CI, 2.8 to 3.3, P = 0.001). After SA history, psychological disorders were the most important risk factor for RSA (IRR 2.7, 95 % CI, 2.1 to 3.6, P = 0.001). Conclusions: Psychological disorders and SA history are the most important factors on RSA. Because of the high prevalence of psychological disorders in SA individuals than the normal population, it is necessary to present psychological and surveillance consultation to suicide attempters to decrease the number of SAs.