The Lancet Regional Health. Europe · Published 2026-07-30 · DOI 10.1016/j.lanepe.2026.101787
Víctor Pérez, Matilde Elices, Carlos Schmidt, Jorge Andreo-Jover, Wala Ayad-Ahmed, Teresa Bobes-Bascarán, Irene Canosa-García, Ana I. Cebria, Ana González-Pinto, Ainoa García-Fernandez, Sandra Gómez-Vallejo, Jennifer Fernández-Fernández, Benedicto Crespo-Facorro, Marina Diaz-Marsá, Iria Grande, Luis Jiménez-Treviño, Elvira Lara, José Luis Ayuso-Mateos, Diego J. Palao, Angela Palao-Tarrero, Natalia Roberto, Miguel Ruiz-Veguilla, Miguel Velasco Santos, Alejandro de la Torre-Luque, Iñigo Alberdi-Paramo, Natalia Angarita, María Ángeles Botí, María Fe Bravo-Ortiz, Guillermo Cano-Escalera, Javier Curto Ramos, Cristina Díaz-Tellez, Verónica Fernández-Rodrigues, Noelia Iglesias, Guillermo Juarez, Luisa Lázaro, Itziar Leal-Leturia, Purificación López, Pablo Mola-Cardenes, Andrés Pemau, Anna Pedrola-Pons, Iván Perez-Diez, Ares Ramos, Julia Rodríguez-Revuelta, Carlamarina Rodríguez-Pereira, Mara Dolores Saiz-Gonzalez, Elisa Seijo-Zazo, Laura Comendador, Lara Suárez-Soto, Alba Toll, Luis Vicenete Valor, Mireia Vázquez, Eduard Vieta, Iñaki Zorrilla, Pilar Alejandra Saiz
Summary: Background: Suicide attempts are a critical public health concern, with a high risk of recurrence after an index attempt. We aimed to identify predictors of suicide reattempt within 12 months. Methods: In this prospective cohort study, we enrolled individuals aged 12 years or older from eight Spanish public hospitals after a suicide attempt (Nov 1, 2020–May 18, 2022). Participants were assessed within 15 days of the index suicide attempt and followed for 12 months. The primary outcome was time to suicide reattempt, documented in electronic clinical records. Cox proportional hazards models were used to identify predictors, adjusting for sex, age, and recruitment site. Individuals with lived experience were involved in the study design. Findings: Of 1730 participants, the mean age was 36.5 years (SD 17.2); 1259 (72.8%) were women and 471 (27.2%) were men. Within 12 months, 340 of 1730 participants (19.7%) reattempted suicide, the median time to reattempt was 140 days (IQR 175, range 7–365). Risk was highest in the first months following the index attempt. Five independent predictors were identified: high psychotropic medication burden (four or five prescribed medications: aHR 2.55, 95% CI 1.57–4.15; p < 0.001), more frequent suicidal ideation (weekly: aHR 1.87, 95% CI 1.25–2.79; p = 0.001; several times per day: aHR 2.07, 95% CI 1.39–3.07; p < 0.001), prior suicide attempts (one to three: aHR 1.62, 95% CI 1.19–2.20; p = 0.002; four or more: aHR 1.80, 95% CI 1.25–2.61; p = 0.001), moderate to severe childhood emotional neglect (aHR 1.56, 95% CI 1.16–2.08; p = 0.002), and non-suicidal self-injury (aHR 1.45, 95% CI 1.09–1.93; p = 0.009). Interpretation: Nearly one in five individuals reattempted suicide within a year of an index attempt. Identified predictors underscore the need for early, targeted, and trauma-sensitive post-attempt interventions. Funding: Instituto de Salud Carlos III and co-funded by the European Union (FEDER).
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Pérez, V., Elices, M., Schmidt, C., et al. (2026). Predictors of suicide attempt recurrence after an index suicide attempt in Spain: a prospective multicentre cohort study. The Lancet Regional Health. Europe. https://doi.org/10.1016/j.lanepe.2026.101787