{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:15:05Z","timestamp":1785406505009,"version":"3.56.0"},"reference-count":75,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":222,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur. Psychiatr."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0924933825100709_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The significant heterogeneity among individuals who die by suicide complicates prevention, suggesting that a \u201cone-size-fits-all\u201d approach is insufficient. It is crucial to identify distinct subgroups for targeted strategies. This study aims to characterize suicide profiles based on trait impulsivity and related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933825100709_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from the FRieNDS project (\n                      <jats:italic>Factores de Riesgo en Defunciones por Suicidio \u2013<\/jats:italic>\n                      Risk Factors in Suicide Deaths), a psychological autopsy study of 408 suicide deaths, were used. After determining the optimal number of clusters via stability analysis through agglomerative nesting, a final cluster analysis was performed on 391 valid suicide deaths (defined as cases with no missing data on the variables used for clustering) using\n                      <jats:italic>k<\/jats:italic>\n                      -means on a lower-dimensional representation of the data encoded by an autoencoder. Key clustering variables included sex, impulsivity (Barratt Impulsivity Scale-11), aggression, intent to die, previous history of suicide attempts, history of substance abuse, psychotic and affective disorders, and the presence of a depressive episode at the time of death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933825100709_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified three clusters: (1) Impulsive-aggressive (29.8%), characterized by high rates of Cluster B disorders, substance abuse, more stressful events, and low lethal intent; (2) depressive prior attempters (24.5%), which comprised mostly women and showed greater behavioural changes before death; and (3) non-impulsive\/aggressive (45.7%), a group with no clear psychopathological profile, less healthcare contact, and minimal communicated intent to die, despite having few prior attempts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0924933825100709_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study identified three suicide clusters with varying impulsivity levels, highlighting the need for tailored interventions and community-level research for better suicide prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/j.eurpsy.2025.10070","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T08:04:47Z","timestamp":1754899487000},"source":"Crossref","is-referenced-by-count":0,"title":["Delineating impulsivity-based pathways to suicide deaths: A cluster analysis"],"prefix":"10.1192","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-0836","authenticated-orcid":false,"given":"Sergio","family":"Sanz-Gomez","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yxnpp24","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Sevilla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0633-2810","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Alacreu-Crespo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012a91z28","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Zaragoza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8697-9327","authenticated-orcid":false,"given":"Elia","family":"Gourgechon-Buot","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051escj72","id-type":"ROR","asserted-by":"publisher"}],"name":"Univ. Montpellier"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-0591","authenticated-orcid":false,"given":"Maria Isabel","family":"Perea-Gonzalez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yxnpp24","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Sevilla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-2639","authenticated-orcid":false,"given":"Jorge Luis","family":"Ordo\u00f1ez-Carrasco","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012a91z28","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Zaragoza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6519-8586","authenticated-orcid":false,"given":"Philippe","family":"Courtet","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051escj72","id-type":"ROR","asserted-by":"publisher"}],"name":"Univ. Montpellier"},{"name":"CHU Montpellier"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5737-110X","authenticated-orcid":false,"given":"Lucas","family":"Giner","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yxnpp24","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Sevilla"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"S0924933825100709_r12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00234-2"},{"key":"S0924933825100709_r49","first-page":"7","article-title":"La valoraci\u00f3n de sucesos vitales: Adaptaci\u00f3n Espa\u00f1ola de la escala de Holmes y Rahe","volume":"4","author":"Gonz\u00e1lez de Rivera","year":"1983","journal-title":"Psiquis (Mexico)"},{"key":"S0924933825100709_r2","article-title":"Suicide and suicide risk","volume":"5","author":"Turecki","year":"2019","journal-title":"Nat Rev Dis Prim"},{"key":"S0924933825100709_r36","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.12m08180"},{"key":"S0924933825100709_r60","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2024.0171"},{"key":"S0924933825100709_r54","volume-title":"R package version 2.2\u201313","author":"Hennig","year":"2024"},{"key":"S0924933825100709_r41","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1"},{"key":"S0924933825100709_r1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(25)00006-4"},{"key":"S0924933825100709_r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2006.01.016"},{"key":"S0924933825100709_r67","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2022.10.008"},{"key":"S0924933825100709_r10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.02.021"},{"key":"S0924933825100709_r39","volume-title":"Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition","author":"First","year":"2002"},{"key":"S0924933825100709_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2023.115492"},{"key":"S0924933825100709_r48","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(67)90010-4"},{"key":"S0924933825100709_r72","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1191-7"},{"key":"S0924933825100709_r43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1986.tb27897.x"},{"key":"S0924933825100709_r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.09.032"},{"key":"S0924933825100709_r57","first-page":"61","article-title":"Endophenotypes and suicide behaviour","volume":"39","author":"Jimenez-Trevi\u00f1o","year":"2011","journal-title":"Actas Esp Psiquiatr"},{"key":"S0924933825100709_r34","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.5512"},{"key":"S0924933825100709_r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.06.029"},{"key":"S0924933825100709_r69","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-014-9811-y"},{"key":"S0924933825100709_r37","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12600"},{"key":"S0924933825100709_r59","doi-asserted-by":"publisher","DOI":"10.1002\/ijop.12724"},{"key":"S0924933825100709_r62","article-title":"Mental pain and suicide: A systematic review of the literature","volume":"7","author":"Verrocchio","year":"2016","journal-title":"Front Psych"},{"key":"S0924933825100709_r25","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v67n1018"},{"key":"S0924933825100709_r61","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.85"},{"key":"S0924933825100709_r44","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(97)00119-4"},{"key":"S0924933825100709_r16","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2015.1051555"},{"key":"S0924933825100709_r4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.11.008"},{"key":"S0924933825100709_r66","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-032511-143109"},{"key":"S0924933825100709_r65","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13864"},{"key":"S0924933825100709_r21","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22039"},{"key":"S0924933825100709_r47","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(83)90065-X"},{"key":"S0924933825100709_r13","doi-asserted-by":"publisher","DOI":"10.1177\/070674371506000605"},{"key":"S0924933825100709_r42","first-page":"147","article-title":"Spanish adaptation of the Barratt impulsiveness scale (BIS-11)","volume":"15","author":"Oquendo","year":"2001","journal-title":"Eur J Psychiatry"},{"key":"S0924933825100709_r29","doi-asserted-by":"publisher","DOI":"10.1177\/0030222818786417"},{"key":"S0924933825100709_r56","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2011.565265"},{"key":"S0924933825100709_r58","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2017.50"},{"key":"S0924933825100709_r73","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30030-X"},{"key":"S0924933825100709_r46","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-003-0425-6"},{"key":"S0924933825100709_r53","unstructured":"[53] Fryda, T , LeDell, E , Gill, N , Aiello, S , Fu, A , Candel, A , et al. h2o: R Interface for the \u201cH2O\u201d Scalable Machine Learning Platform. Vienna, Austria: R Found Stat Comput 2024."},{"key":"S0924933825100709_r31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180292"},{"key":"S0924933825100709_r23","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v68n0509"},{"key":"S0924933825100709_r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2014.11.019"},{"key":"S0924933825100709_r68","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(96)00217-X"},{"key":"S0924933825100709_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.03.002"},{"key":"S0924933825100709_r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2022.07.048"},{"key":"S0924933825100709_r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.04.068"},{"key":"S0924933825100709_r70","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.10.065"},{"key":"S0924933825100709_r50","doi-asserted-by":"publisher","DOI":"10.1017\/S003329170002105X"},{"key":"S0924933825100709_r45","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.47.2.343"},{"key":"S0924933825100709_r40","volume-title":"Structured clinical interview for DSM-IV-TR Axis II personality disorders (SCID-II) version 2.0","author":"First","year":"1994"},{"key":"S0924933825100709_r20","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709990808"},{"key":"S0924933825100709_r52","volume-title":"R: a Language and Environment for Statistical Computing [Computing Software]","year":"2024"},{"key":"S0924933825100709_r38","volume-title":"Diferencias en la conducta suicida. Estudio comparativo entre los intentos de suicidio y suicidio consumado","author":"Giner","year":"2010"},{"key":"S0924933825100709_r5","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000084"},{"key":"S0924933825100709_r9","first-page":"1","article-title":"Sex differences in determinants of suicide risk preceding psychiatric admission: An electronic medical record study","volume":"13","author":"McQuaid","year":"2022","journal-title":"Front Psych"},{"key":"S0924933825100709_r24","doi-asserted-by":"publisher","DOI":"10.1177\/0020764016688041"},{"key":"S0924933825100709_r51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.05.017"},{"key":"S0924933825100709_r17","first-page":"215","article-title":"Psychometric characteristics of Chinese version of Barratt impulsiveness scale-11 in suicides and living controls of rural China","volume":"66","author":"Lu","year":"2012","journal-title":"Omega (United States)"},{"key":"S0924933825100709_r32","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2017.123"},{"key":"S0924933825100709_r63","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-021815-093204"},{"key":"S0924933825100709_r55","volume-title":"Why People Die by Suicide: Further Development and Tests of the Interpersonal-Psychological Theory of Suicidal Behavior","author":"Joiner","year":"2012"},{"key":"S0924933825100709_r33","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115952"},{"key":"S0924933825100709_r11","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)70222-6"},{"key":"S0924933825100709_r71","doi-asserted-by":"publisher","DOI":"10.1038\/srep25770"},{"key":"S0924933825100709_r74","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2004.02.015"},{"key":"S0924933825100709_r30","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23577"},{"key":"S0924933825100709_r75","article-title":"Reliability and validity of proxy reports of impulsivity and aggression: An evidence-based assessment approach to psychological autopsy methods","author":"Sanz-G\u00f3mez","year":"2023","journal-title":"Spanish J Psychiatry Ment Heal"},{"key":"S0924933825100709_r8","first-page":"31","article-title":"Sex differences in suicide mortality in Newfoundland and Labrador: An observational study with medical examiner data from 1997 to 2016","volume":"33","author":"Wilson","year":"2022","journal-title":"Heal Reports"},{"key":"S0924933825100709_r22","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.11.2116"},{"key":"S0924933825100709_r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.06.031"},{"key":"S0924933825100709_r64","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.2101"},{"key":"S0924933825100709_r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2023.01.007"},{"key":"S0924933825100709_r18","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa036"}],"container-title":["European Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924933825100709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T16:12:08Z","timestamp":1759853528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924933825100709\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":75,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0924933825100709"],"URL":"https:\/\/doi.org\/10.1192\/j.eurpsy.2025.10070","relation":{},"ISSN":["0924-9338","1778-3585"],"issn-type":[{"value":"0924-9338","type":"print"},{"value":"1778-3585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e114"}}