Suicide Attempters Compared to Intentional Self-Harm Have a Severe Suicidal Intention and Poorer Reasons for Living Soon after Their Attempts: A Hospital-Based Cross-Sectional Study

Abstract

Abstract Background: Suicidal intent after an attempt remains high, while in some studies, a cathartic effect was reported. Many subjects do not take adequate precautions despite a previous attempt. Aims and Objectives: To evaluate the severity of suicidal intent after an attempted suicide in comparison to intentional self-harm (ISH) soon after an attempt and assess activating and protective factors in both these conditions. Materials and Methods: In a tertiary hospital, soon after ISH or suicidal attempt (SA), cross-sectional data were collected on socio demographics, attempts, Beck’s suicidal intent scale, Columbia suicide severity rating scale, and brief reasons for living (BRL) scale and analyzed. Results: 21 SAs and 16 ISH were identified. Mean of severe suicide intent in SA (29. 56) was higher than ISH (25.52). ISH had higher scores on impulsive behavior 17 (81%) than 10 SA (62.5%), better identification of protective factors in ISH 20 (95.2%) than 11 (68.8%) in SA group. Better recognition of social networks and support in ISH group 18 (85.7%) than suicide attempters 10 (47.6%). SA group had significant negative correlations between BIS and BRL on responsibility to family rho = −0.55, P = 0.03. Hopelessness and impulsivity showed no effect on suicidal intention on ANOVA. Conclusions: Assessment of suicidal intent is important soon after SA and ISH. In ISH, suicidal intent appears suppressed. Higher impulsiveness was seen in ISH group but was able to identify reasons for living better than SA group. Suicidal intent, impulsivity, and hopelessness appear to be independent factors of each other.