Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization

Bojan Mirkovic, David Cohen, Sébastien Garny de la Rivière, Hugues Pellerin, Jean Marc Guilé, Angèle Consoli, Priscille Gerardin

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Suicide attempts (SAs) are a public health concern in adolescence. A brief hospitalization is recommended, but access to inpatient wards is often not available. In addition, numerous risk factors for SA recurrence have been identified, but few studies have explored protective factors. Here, we aimed to assess the role of both risk and protective factors on SA relapse in a context of free access to inpatient services. We performed a prospective follow-up study of 320 adolescents who were hospitalized for an SA between January 2011 and December 2014 in France. Assessments at baseline included socio-demographics, clinical characteristics, temperament, reasons for living, spirituality, and coping. Patients were re-evaluated at 6 months and 12 months for depression severity and SA relapse. A total of 135 and 91 patients (78 girls, 12 boys, aged 13–17) were followed up at 6 and 12 months, respectively. At the 12-month follow-up, 28 (30%) subjects had repeated an SA. Adolescents who either had a history of SA or were receiving psychotropic treatment at baseline were at higher risk of recurrence. Several variables had a protective effect: (1) productive coping skills, namely, working hard and achieving, physical recreation, and seeking relaxing diversions; (2) a particular temperament trait, namely, cooperativeness; and (3) having experienced more life events. We also found a significant interaction: the higher the depression score during follow-up, the lower the protective effect of productive coping. Our findings confirm that a history of SA and seeking psychiatric care with medication are risk factors for SA relapse. However, productive coping strategies and cooperativeness are protective factors, and the improvement of such strategies as well as treatment of persisting depression should be a goal of psychotherapy treatment offered to suicidal adolescents.

Original languageEnglish
Pages (from-to)1729-1740
Number of pages12
JournalEuropean Child and Adolescent Psychiatry
Issue number12
StatePublished - 1 Dec 2020
Externally publishedYes


  • Adolescent
  • Cohort study
  • Coping
  • Protective factor
  • Suicidal behaviour
  • Suicide attempt


Dive into the research topics of 'Repeating a suicide attempt during adolescence: risk and protective factors 12 months after hospitalization'. Together they form a unique fingerprint.

Cite this