Association between hypomentalizing and suicide reattempt: a 12-month follow-up study

Hypomentalizing has been related with an increased risk of suicide attempt (SA). Although certain studies have identified an association between hypomentalizing and suicidal behavior, research on follow-up remains limited. This study aims to examine the relationship between hypomentalizing and suicide reattempt within 12-months after SA. This longitudinal study encompassed a cohort of 1373 patients who have survived a SA. Assessments were conducted at the baseline and at a 12-month follow-up. We measured hypomentalizing using the RFQ-8, and we used the CSRSS to evaluate suicidal ideation and behavior. We compared demographic and clinical variables with Student’s t-tests and chi-square. Regression models were employed to investigate the relationship between hypomentalizing and the suicide reattempt. A total of 310 participants reattempted suicide in the follow-up period. After controlling for study variables, our results showed that age (aOR = 0.977, 95% CI 0.961–0.994), follow-up suicidal ideation (aOR = 3.165, 95% CI 1.578–6.349), baseline and follow-up suicide plan (aOR = 0.549, 95% CI 0.312–0.967; aOR = 2.417, 95% CI = 1.261–4.632), and the lifetime number of SA (aOR = 1.286, 95% CI 1.199–1.379), were associated with an increased risk of reattempt within the 12-month follow-up. Univariate regression analyses showed an association between baseline and follow-up hypomentalizing and suicide reattempt (OR = 1.160, 95% CI = 1.050–1.281; OR = 1.484, 95% CI = 1.259–1.750). Social cognition may play a crucial role in the risk of suicide reattempt. Future research on the association between mentalizing and suicidal behavior could help identify comorbid risk factors and design effective therapeutic strategies.