Lethality Patterns in Multiple Suicide Attempts*

ABSTRACT: There are few studies in the suicide literature where persons who make more than one suicide attempt are compared with persons who make only a single attempt. The present study investigated all patients (N = 347) who had come to Massachusetts General Hospital with a suicide attempt in 1965. In this group of patients, the 43 who had made multiple attempts were compared with a randomly selected group of 96 patients who had made only a single attempt. When compared to single attempters, multiple attempters made their initial attempt at an earlier age and at a lower lethal level (as measured by the Risk‐Rescue Rating), had a more intense history of prior psychiatric treatment, and received more psychiatric treatment subsequent to the first attempt. Multiple attempters did not differ from single attempters with regard to sex, race, religion, or marital status at the time of the first attempt. Within the group of multiple attempters two subgroups emerged: (a) those who were younger, whose initial lethality level was lower, and who had shorter time intervals between attempts; and (b) those who were older, had higher initial lethality levels, and had longer time periods between attempts. For both subgroups, receiving psychiatric treatment following the first attempt lowered the lethality of their second attempt. Multiple regression analysis was employed to predict the lethal level of a subsequent attempt, should such occur. This predictive equation and the descriptive differences cited above may have direct implications for the management of suicidal persons.