{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:55:26Z","timestamp":1781592926301,"version":"3.54.5"},"reference-count":0,"publisher":"Juan Jos\u00e9 L\u00f3pez-Ibor Foundation","issue":"3","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Actas Esp Psiquiatr"],"abstract":"<jats:p>Background: Individuals who die by suicide may differ depending on whether the fatal act istheir first attempt or follows previous non-fatal attempts. Understanding these differences may help refine prevention strategies.\nMethods: We conducted a cross-sectional analysis within the MCOSUL Cohort, a clinical registry of all patients treated for a suicide attempt in two general hospitals in Lleida, Spain. We included all cohort members who died by suicide between January 2009 and December 2022. Sociodemographic, clinical, and method-related variables were compared between first-attempt and repeat-attempt fatalities. Variables with p &lt; 0.20 in bivariate analyses were entered into a multivariable logistic regression model to identify independent predictors of first-attempt fatalities.\nResults: Among 117 suicide deaths, 38 (32.5%) occurred at the first attempt and 79 (67.5%) after one or more prior non-fatal attempts. Repeat-attempt fatalities had a mean of 1.89 (SD = 1.73) attempts from cohort entry to death. In multivariable analysis, unemployment (OR = 0.17, 95% CI: 0.04\u20130.66, p = 0.011) and recognized disability (OR = 0.20, 95% CI: 0.04\u20130.80, p = 0.035) were less frequent among first-attempt fatalities, indicating they were more common in those who died after repeated attempts. No significant differences were found for age, sex, alcohol use, psychiatric diagnosis, or fatal attempt method.\nConclusions: Unemployment and recognized disability (formal legal\/administrative disability certification issued by relevant regional authorities, which may encompass physical and\/or psychiatric disabilities) appear to characterize individuals who die by suicide after a series of non-fatal attempts, suggesting a subgroup with a more prolonged suicidal course that may benefit from sustained engagement and prevention strategies.<\/jats:p>","DOI":"10.62641\/aep.v54i3.2220","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:33:23Z","timestamp":1781591603000},"page":"657-662","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for First-Attempt Suicide Fatalities: Evidence From the MCOSUL Cohort"],"prefix":"10.62641","volume":"54","author":[{"given":"Eug\u00e8nia","family":"Nicolau-Subires","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Irigoyen-Oti\u00f1ano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Jov\u00e9-Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Arenas-Pijoan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e8n","family":"Gavil\u00e0-Esquerdo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"P\u00e1mpols-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gallart-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Marina","family":"Lao-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Dom\u00e8nech-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Jim\u00e9nez-Mayoral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicent","family":"Llorca-Bof\u00ed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"48925","published-online":{"date-parts":[[2026,6,15]]},"container-title":["Actas Espa\u00f1olas de Psiquiatr\u00eda"],"original-title":[],"link":[{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/download\/2220\/2896","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/download\/2220\/2896","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:33:23Z","timestamp":1781591603000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaspsiquiatria.es\/index.php\/actas\/article\/view\/2220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,15]]}},"URL":"https:\/\/doi.org\/10.62641\/aep.v54i3.2220","relation":{},"ISSN":["1578-2735","1139-9287"],"issn-type":[{"value":"1578-2735","type":"electronic"},{"value":"1139-9287","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}