Psychosocial and clinical characteristics of individuals who have attempted suicide

Suicide attempts and non-suicidal self-injury (NSSI) are a significant problem, particularly among individuals of working age. Despite theoretical differences, in clinical practice, determining a patient's true intentions is challenging: motivations may overlap, change during interviews, or be deliberately concealed. These difficulties highlight the need for an in-depth study of the factors influencing nature and direction of suicidal behavior. The aim of this study was to evaluate the relationships between suicidal intent and psychosocial and clinical characteristics in patients who have committed suicide attempt (SA). The study hypothesis is that patients aged 18 to 40 with a diagnosis of personality disorder and motives for self-harm related to the desire to influence the situation or significant others are more likely to commit acts of self-harm without an expressed intent to die. Materials and methods: clinical interview, analysis of case histories, Beck Depression Inventory, Beck Anxiety Scale, Loneliness Scale. The study included 119 patients admitted to the Sklifosovsky Research Institute of Emergency Care (Moscow) after a suicide. The subjects were divided into two groups: 40 (33.6%) with the intent to die; 79 (66.4%) indicated other intentions (emotional regulation, influence on the situation or loved ones). Results. Among patients with suicidal intent, there have been reported more people aged 45–59 rather than in the group who did not demonstrate such intent (61.5 % versus 38.5%). Suicidal intent was more often reported by men (46.5 % versus 27.3%, p=0.04). Individuals with suicidal intent, among the reasons for suicide, more often reported depressed mood, namely feelings of sadness, loneliness, despondency, than patients without such intent (61.1%, p=0.001). Among those who attempted suicide, the presence of suicidal intent was statistically significantly associated with a higher frequency of diagnosis of affective disorders (53.1%, p=0.005), including moderate depression, compared with patients who did not have an expressed intent to die (26.3% versus 7.9%).Younger individuals more often committed suicide without the intent to die (68.9%), most common causes of suicide were conflicts with significant loved ones (81.7%, p=0.001). In this category of subjects, the diagnosis of personality disorder was predominant, while pronounced symptoms of depression were absent (78.8%). Conclusion. The study found a correlation between suicidal intent and the patients' psychosocial and clinical characteristics. Patients who exhibited suicidal intent had moderate depression, were predominantly 45–59 years of age, were male, and experienced significant feelings of social isolation. At the same time, patients who identified suicidal intent as a desire for emotional regulation or an attempt to resolve a conflict with loved ones were statistically significantly more likely to be young and to have significant difficulties in interpersonal communication. These patients were more often diagnosed with personality disorders, while depressive symptoms were absent or did not reach clinically significant levels. These findings should be taken into account when providing assistance to patients after a suicide attempt.