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Sense of coherence and suicidality in suicide attempters: a prospective study

Authors


N. Sjöström, Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Box 457, SE 405 30, Göteborg, Sweden, E-mail: nils.sjostrom@gu.se

Abstract

Accessible summary

  • • The usefulness of the Sense of Coherence (SOC) scale in the nursing setting is well-established.
  • • The aim of this prospective clinical study was to test whether low SOC predicted future suicidality in suicide attempters.
  • • Low SOC at index attempt was associated with suicidality at 2-month follow-up, and associations were independent of major depression and symptom burden.
  • • Low SOC at index attempt was associated with repeat self-harm during a 3-year observation period. However, the association did not remain after adjustment for depression and symptom burden.
  • • The SOC may help to identify patients at continued risk for suicidal behaviour.

Abstract

The usefulness of the Sense of Coherence (SOC) scale in the nursing setting is well-established, and an association between SOC and suicidality has been suggested. The aim was to test whether low SOC at index attempt is an independent predictor of suicidality at 2-month follow-up and of risk for repeat attempt. The study, which had a prospective cross-sectional design, included patients admitted to hospital after a suicide attempt. They were interviewed by means of Structured Clinical Interview for DSM-IV. Participants (n= 155) completed the SOC scale and the Comprehensive Psychopathological Self-rating Scale for Affective Syndromes. Suicidality was rated with the Suicide Assessment Scale. Instruments were employed again at follow-up. Non-fatal/fatal repetition within 3 years was determined by review of hospital records. Low SOC at baseline predicted high suicidality at follow-up. The association remained after adjustment for major depression and affective symptom burden. Repeat attempts were made by 54 persons. Low baseline SOC was associated with repeat attempt, but the association did not remain after adjustment for major depression and symptom burden. Low SOC ratings could be a marker of risk for high suicidality in the aftermath of a suicide attempt. The SOC scale could be incorporated in nursing assessments of suicide attempters.

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