Multiple attempters of suicide presenting at an emergency department.

As part of a study involving seven hundred and forty-seven (747) consecutive cases of self-injury presenting at the emergency department of an inner city hospital, data pertaining to a multiple attempt group of ninety-nine subjects were compared with the data pertaining to first attempters. All subjects were rated on Beck's Lethality Scales, Intent Scale and Hopelessness Scale. In addition, a standard interview was conducted to provide psychosocial information. Of the total suicide attempt population, 14% can be considered chronic. The multiple attempters were found to show more chronicity in their symptomatology, poorer coping histories, a positive family history of suicidal behaviour and a positive history of alcohol and drug abuse, all at a statistically significant level compared with first-time attempters. The multiple attempters also tend to show higher lethality and depression ratings, less impulsiveness and are significantly more often admitted to the in-patient unit following the attempt, than first attempters. Their intent scores were significantly related to their sense of hopelessness, which may be a reflection of their basic feelings of inadequacy. It was concluded that the multiple or "chronic" attempter differed sufficiently from the first-time attempter to warrant special intervention strategies.