Suicide Reattempt Risk Factors: A Cross-Sectional Study Using Mashhad's Population-Based Registry, 2019-2022
-
Amin Moradi
,
Fateme Nikbakht
,
Ali Taghipour
,
Hamid Reza Fathi
,
Behnaz Beygi
,
Khadijeh Ghasemi
,
Zahra Amiri
,
Ehsan Mosafarkhani
Abstract
Background: Suicide is a serious global public health issue, which is the fourth-leading cause of death for young people between the ages of 15 and 29. This study aimed to be conducted to investigate the factors affecting suicide reattempts.
Methods: This cross-sectional study used data from the Sina Electronic Health Registration System and the HIS of Mashhad University of Medical Sciences, Mashhad, Iran covering around 90% of suicide attempts in Mashhad’s government hospitals (2019–2022). The study population included all Mashhad residents with documented suicide attempts in this period. Descriptive analysis was followed by a Poisson multivariable regression to identify factors affecting suicide attempt frequency, with analyses conducted in Stata version 14 and significance set at P<0.05.
Results: Among 5,737 participants, 3,157 (55.0%) were men. The overall rate of suicide reattempt was 10.1% (n=580). Suicide reattempts were more prevalent among men (55.5% of reattempts, n=322), individuals with mental disorders (16.0%, n=93), substance users (7.8%, n=45), single persons (66.6%, n=386), those with high school education (47.6%, n=276), and self-employed individuals (45.7%, n=265). Poisson regression analysis revealed that substance users had a 43% higher likelihood of reattempting suicide compared to non-users (IRR=1.43, 95% CI: 1.27-1.61, p<0.001), after adjusting for other variables.
Conclusion: Identifying risk factors for suicide reattempt, such as drug abuse, may be effective in identifying high-risk groups and preventing suicide reattempts.
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2. Organization WH Suicide worldwide in 2019: https://www.who.int/publications/i/item/9789240026643
3. Mirhashemi S MM, Mirhashemi AH, Taghipour H, Danial Z (2016). Suicide in Iran. The Lancet, 387 (10013):29.
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5. Palmiere C, Risso E, van Hecke O, La Harpe R (2007). Unplanned complex suicide by self-strangulation associated with multiple sharp force injuries: a case report. Med Sci Law, 47 (3):269-73.
6. Song HB, Lee SA (2016). Socioeconomic and lifestyle factors as risks for suicidal behavior among Korean adults. J Affect Disord, 197:21-8.
7. Racine M, Sánchez-Rodríguez E, Gálan S, et al (2017). Factors Associated with Suicidal Ideation in Patients with Chronic Non-Cancer Pain. Pain Med, 18 (2):283-293.
8. Sadock BJ, Sadock VA, Ruiz P (2015). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Wolters Kluwer/Lippincott Williams & Wilkins.
9. Christiansen E, Jensen BF (2009). A nested case-control study of the risk of suicide attempts after discharge from psychiatric care: the role of co-morbid substance use disorder. Nord J Psychiatry, 63 (2):132-9.
10. Wong JP, Stewart SM, Claassen C, Lee PW, Rao U, Lam TH (2008). Repeat suicide attempts in Hong Kong community adolescents. Soc Sci Med, 66 (2):232-41.
11. Esmaeili ED, Farahbakhsh M, Sarbazi E, Khodamoradi F, Gaffari Fam S, Azizi H (2022). Predictors and incidence rate of suicide re-attempt among suicide attempters: A prospective study. Asian J Psychiatr, 69:102999.
12. Heyerdahl F, Bjornaas MA, Dahl R, et al (2009). Repetition of acute poisoning in Oslo: 1-year prospective study. Br J Psychiatry, 194 (1):73-9.
13. Shakeri MT, Dadpour B, Vafaeinezhad R, et al (2021). 'The study of epidemiological and geographical pattern of suicide attempt in Mashhad, Iran: 2016. Medical Journal of Mashhad university of Medical Sciences, 63(6), pp. 3053-3065
14. Daliri S, Bazyar J, Sayehmiri K, Delpisheh A, Sayehmiri F (2017). The incidence rates of suicide attempts and successful suicides in seven climatic conditions in Iran from 2001 to 2014: a systematic review and meta-analysis. Scientific Journal of Kurdistan University of Medical Sciences, 21 (6):1-15.
15. Daliri S, Bazyar J, Sayehmiri K, Delpisheh A, Sayehmiri F (2017). The incidence rates of suicide attempts and successful suicides in seven climatic conditions in Iran from 2001 to 2014: a systematic review and meta-analysis. Scientific Journal of Kurdistan University of Medical Sciences, 21(6):1-15.
16. Basu S, Dixit S (2022). Increasing Choices or Decreasing Hope? Explaining the Rising Prevalence of Depression From a Decision-Making Perspective. Psychol Rep, 125 (2):681-702.
17. Alvarez-Galvez J, Suarez-Lledo V, Salvador-Carulla L, Almenara-Barrios J (2021). Structural determinants of suicide during the global financial crisis in Spain: Integrating explanations to understand a complex public health problem. PLoS One, 16 (3):e0247759.
18. Norouzi M, Amiri Z, Farkhani EM, Hoseini SJ, Khosravi Asl T (2024). Advancing Healthcare Infrastructure: The Features of Iran’s Sina Electronic Health Record System. Epidemiol Health System J, 11 (2):48-54.
19. Amiri Z, Sadeghi M, Moradi A, Paydar M, Norouzi M, Mosafarkhani E (2024). Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study. J Res Health Sci, 24 (4):e00630.
20. Miranda-Mendizabal A, Castellví P, Parés-Badell O, et al (2019). Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health, 64 (2):265-283.
21. Canetto SS, Sakinofsky I (1998). The gender paradox in suicide. Suicide Life Threat Behav, 28 (1):1-23.
22. Bachmann S (2018). Epidemiology of Suicide and the Psychiatric Perspective. Int J Environ Res Public Health, 15 (7).
23. Chen J, Lui ID, Hsu YC, Yip PSF (2024). Patterns in suicide by marital status in Hong Kong, 2002-2020: Is marriage still a protective factor against suicide? J Affect Disord, 346:31-39.
24. Calati R, Ferrari C, Brittner M, et al (2019). Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord, 245:653-667.
25. Kyung-Sook W, SangSoo S, Sangjin S, Young-Jeon S (2018). Marital status integration and suicide: A meta-analysis and meta-regression. Soc Sci Med, 197:116-126.
26. Assari S, Schatten HT, Arias SA, et al (2019). Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks. J Racial Ethn Health Disparities, 6 (5):1001-1010.
27. Phillips JA, Hempstead K (2017). Differences in U.S. Suicide Rates by Educational Attainment, 2000-2014. Am J Prev Med, 53 (4):e123-e130.
28. Okamoto N, Ikenouchi A, Chibaatar E, et al (2023). Risk Factors in Japanese Drug Overdose Patients: Identifying Their Associations With Suicide Risk. Omega (Westport):302228231166970.
29. Pompili M, Serafini G, Innamorati M, et al (2012). Substance abuse and suicide risk among adolescents. Eur Arch Psychiatry Clin Neurosci. doi: 10.1007/s00406-012-0292-0.
30. Esang M, Ahmed S (2018). A Closer Look at Substance Use and Suicide. American Journal of Psychiatry Residents' Journal, 13.2018;13.
31. Burón P, Jimenez-Trevino L, et al (2016). Reasons for Attempted Suicide in Europe: Prevalence, Associated Factors, and Risk of Repetition. Arch Suicide Res, 20 (1):45-58.
32. Forte A, Trobia F, Gualtieri F, et al (2018). Suicide Risk among Immigrants and Ethnic Minorities: A Literature Overview. Int J Environ Res Public Health, 15(7):1438.
33. Cha CB, Franz PJ, E MG, Glenn CR, Kleiman EM, Nock MK (2018). Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry, 59 (4):460-482.
2. Organization WH Suicide worldwide in 2019: https://www.who.int/publications/i/item/9789240026643
3. Mirhashemi S MM, Mirhashemi AH, Taghipour H, Danial Z (2016). Suicide in Iran. The Lancet, 387 (10013):29.
4. Khadem Rezaiyan M, Jarahi L, Moharreri F, et al (2017). Epidemiology of Suicide Attempts in Khorasan Razavi Province, 2014-2015. Iranian Journal of Epidemiology, 13 (2):128-135.
5. Palmiere C, Risso E, van Hecke O, La Harpe R (2007). Unplanned complex suicide by self-strangulation associated with multiple sharp force injuries: a case report. Med Sci Law, 47 (3):269-73.
6. Song HB, Lee SA (2016). Socioeconomic and lifestyle factors as risks for suicidal behavior among Korean adults. J Affect Disord, 197:21-8.
7. Racine M, Sánchez-Rodríguez E, Gálan S, et al (2017). Factors Associated with Suicidal Ideation in Patients with Chronic Non-Cancer Pain. Pain Med, 18 (2):283-293.
8. Sadock BJ, Sadock VA, Ruiz P (2015). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Wolters Kluwer/Lippincott Williams & Wilkins.
9. Christiansen E, Jensen BF (2009). A nested case-control study of the risk of suicide attempts after discharge from psychiatric care: the role of co-morbid substance use disorder. Nord J Psychiatry, 63 (2):132-9.
10. Wong JP, Stewart SM, Claassen C, Lee PW, Rao U, Lam TH (2008). Repeat suicide attempts in Hong Kong community adolescents. Soc Sci Med, 66 (2):232-41.
11. Esmaeili ED, Farahbakhsh M, Sarbazi E, Khodamoradi F, Gaffari Fam S, Azizi H (2022). Predictors and incidence rate of suicide re-attempt among suicide attempters: A prospective study. Asian J Psychiatr, 69:102999.
12. Heyerdahl F, Bjornaas MA, Dahl R, et al (2009). Repetition of acute poisoning in Oslo: 1-year prospective study. Br J Psychiatry, 194 (1):73-9.
13. Shakeri MT, Dadpour B, Vafaeinezhad R, et al (2021). 'The study of epidemiological and geographical pattern of suicide attempt in Mashhad, Iran: 2016. Medical Journal of Mashhad university of Medical Sciences, 63(6), pp. 3053-3065
14. Daliri S, Bazyar J, Sayehmiri K, Delpisheh A, Sayehmiri F (2017). The incidence rates of suicide attempts and successful suicides in seven climatic conditions in Iran from 2001 to 2014: a systematic review and meta-analysis. Scientific Journal of Kurdistan University of Medical Sciences, 21 (6):1-15.
15. Daliri S, Bazyar J, Sayehmiri K, Delpisheh A, Sayehmiri F (2017). The incidence rates of suicide attempts and successful suicides in seven climatic conditions in Iran from 2001 to 2014: a systematic review and meta-analysis. Scientific Journal of Kurdistan University of Medical Sciences, 21(6):1-15.
16. Basu S, Dixit S (2022). Increasing Choices or Decreasing Hope? Explaining the Rising Prevalence of Depression From a Decision-Making Perspective. Psychol Rep, 125 (2):681-702.
17. Alvarez-Galvez J, Suarez-Lledo V, Salvador-Carulla L, Almenara-Barrios J (2021). Structural determinants of suicide during the global financial crisis in Spain: Integrating explanations to understand a complex public health problem. PLoS One, 16 (3):e0247759.
18. Norouzi M, Amiri Z, Farkhani EM, Hoseini SJ, Khosravi Asl T (2024). Advancing Healthcare Infrastructure: The Features of Iran’s Sina Electronic Health Record System. Epidemiol Health System J, 11 (2):48-54.
19. Amiri Z, Sadeghi M, Moradi A, Paydar M, Norouzi M, Mosafarkhani E (2024). Association Between Household Food Insecurity and Low Birth Weight: A Population-Based Case-Control Study. J Res Health Sci, 24 (4):e00630.
20. Miranda-Mendizabal A, Castellví P, Parés-Badell O, et al (2019). Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health, 64 (2):265-283.
21. Canetto SS, Sakinofsky I (1998). The gender paradox in suicide. Suicide Life Threat Behav, 28 (1):1-23.
22. Bachmann S (2018). Epidemiology of Suicide and the Psychiatric Perspective. Int J Environ Res Public Health, 15 (7).
23. Chen J, Lui ID, Hsu YC, Yip PSF (2024). Patterns in suicide by marital status in Hong Kong, 2002-2020: Is marriage still a protective factor against suicide? J Affect Disord, 346:31-39.
24. Calati R, Ferrari C, Brittner M, et al (2019). Suicidal thoughts and behaviors and social isolation: A narrative review of the literature. J Affect Disord, 245:653-667.
25. Kyung-Sook W, SangSoo S, Sangjin S, Young-Jeon S (2018). Marital status integration and suicide: A meta-analysis and meta-regression. Soc Sci Med, 197:116-126.
26. Assari S, Schatten HT, Arias SA, et al (2019). Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks. J Racial Ethn Health Disparities, 6 (5):1001-1010.
27. Phillips JA, Hempstead K (2017). Differences in U.S. Suicide Rates by Educational Attainment, 2000-2014. Am J Prev Med, 53 (4):e123-e130.
28. Okamoto N, Ikenouchi A, Chibaatar E, et al (2023). Risk Factors in Japanese Drug Overdose Patients: Identifying Their Associations With Suicide Risk. Omega (Westport):302228231166970.
29. Pompili M, Serafini G, Innamorati M, et al (2012). Substance abuse and suicide risk among adolescents. Eur Arch Psychiatry Clin Neurosci. doi: 10.1007/s00406-012-0292-0.
30. Esang M, Ahmed S (2018). A Closer Look at Substance Use and Suicide. American Journal of Psychiatry Residents' Journal, 13.2018;13.
31. Burón P, Jimenez-Trevino L, et al (2016). Reasons for Attempted Suicide in Europe: Prevalence, Associated Factors, and Risk of Repetition. Arch Suicide Res, 20 (1):45-58.
32. Forte A, Trobia F, Gualtieri F, et al (2018). Suicide Risk among Immigrants and Ethnic Minorities: A Literature Overview. Int J Environ Res Public Health, 15(7):1438.
33. Cha CB, Franz PJ, E MG, Glenn CR, Kleiman EM, Nock MK (2018). Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry, 59 (4):460-482.
| Files | ||
| Issue | Vol 54 No 4 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Suicide Suicide reattempt Risk factors Iran Poisson multivariate | ||
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How to Cite
1.
Moradi A, Nikbakht F, Taghipour A, Fathi HR, Beygi B, Ghasemi K, Amiri Z, Mosafarkhani E. Suicide Reattempt Risk Factors: A Cross-Sectional Study Using Mashhad’s Population-Based Registry, 2019-2022. Iran J Public Health. 2025;54(4):860-869.
