Delineating impulsivity-based pathways to suicide deaths: A cluster analysis

Sanz-Gomez, Sergio ; Alacreu-Crespo, Adrián (Universidad de Zaragoza) ; Gourgechon-Buot, Elia ; Perea-Gonzalez, Maria Isabel ; Ordoñez-Carrasco, Jorge Luis (Universidad de Zaragoza) ; Courtet, Philippe ; Giner, Lucas

Resumen: Background: The significant heterogeneity among individuals who die by suicide complicates prevention, suggesting that a “one-size-fits-all” 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.
Methods: Data from the FRieNDS project (Factores de Riesgo en Defunciones por Suicidio – 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 k-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.
Results: 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.
Conclusion: 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.

Idioma: Inglés

DOI: 10.1192/j.eurpsy.2025.10070

Año: 2025

Publicado en: EUROPEAN PSYCHIATRY 68, 1 (2025), e114 [13 pp.]
ISSN: 0924-9338

Tipo y forma: Article (Published version)

Área (Departamento): Área Metod.Ciencias Comportam. (Dpto. Psicología y Sociología)
Área (Departamento): Área Person.Eval.Trat.Psicoló. (Dpto. Psicología y Sociología)