Continuous Suicide Attempts

Suicide attempt is defined as a self-inflicted, potentially injurious behaviour with a nonfatal outcome for which there is evidence of intent to die; a suicide attempt may result in no injuries, or death. The existing literature is heterogeneous about the operational definition of “suicide reattempters”. Some studies suggest that SRs can be defined as such after an “index” suicide attempt, or that they are patients who committed two or more suicide attempts; other Authors consider SRs those who made three or more suicide attempts. 

Although this may represent a limitation, nonetheless we should be aware that in clinical ER settings clinicians are often compelled to work without the possibility to use scales and clinical interviews which are likely used afterwards, for instance if the patient is referred to the Psychiatry Ward. The clinician-rated actual intent to die may be higher in SSAs than in SRs, and that the latter may be more likely to perform attempts on an impulsive basis.

The existing literature is heterogeneous about the operational definition of “suicide reattempters” (SRs): some studies suggest that SRs can be defined as such after an “index” suicide attempt, or that they are patients who committed two or more suicide attempts; other Authors consider SRs those who made three or more suicide attempts. 

Furthermore the existing literature defines as “grand repeaters” patients with four or more suicide attempts (Mendez-Bustos et al.,2013). Despite these limitations, several studies have investigated the possible socio-demographic, psychological and clinical correlates of SRs. Nonetheless, the identification of predictors for repetition of non-fatal suicide attempts is difficult, and it is even more difficult for suicide deaths. Moreover, some predictors for initial, non-fatal attempts may prove weaker predictors for non-fatal repetition (Beghi, Rosenbaum, Cerri & Cornaggia, 2013