Risk and protective factors of near-lethal suicide attempts in adolescents

Introduction: Adolescents exhibit high rates of suicide attempts but comparatively low rates of suicides. While many studies focus on suicide attempts, it is unclear if findings apply to suicides. Studying near-lethal suicide attempts (NLSA) as approximations of suicides is an underexplored approach. This study aimed to identify differences between lower-risk suicide attempts (LRSA) and NLSA. Methods: Using a standardized clinical survey, suicidal phenomena, risk and protective factors were assessed in a clinical population at first contact from 2018 to 2022. NLSA (N = 17) were identified using strict criteria and compared with LRSA (N = 106) in terms of risk and protective factors using χ² and t-tests for independent samples. Results: 84.0%; χ²(1)=5.895, p=.015). This suggests that a history of suicide attempts as an explicit warning sign is less often present in patients with NLSA. Adolescents with NLSA also showed lower levels of both passive and active communication: 73.3% had never been approached by others about suicidality (LRSA: 14.1%; U = 243.500, p