Prevalence and associated factors of a repeat of suicide attempt among individuals attending an emergency department in Oman.

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Salim AL-Huseini, Mundher Al Maqbali, Hassan Mirza, Mahmood Alkhatri, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4578008/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: This study aims to determine the rate of re-attempted suicide among individuals with a prior history of suicidal attempts. Additionally, it seeks to identify factors that could potentially predict future suicide re-attempts. Methods: We retrospectively collected medical data on patients under 18 years of age who were admitted to our emergency department after attempting suicide. We evaluated the general characteristics of the patients. We divided them into two groups: patients who had made multiple suicide attempts and patients who attempted suicide for the first time. Logistic regression analysis was performed. Results: A total of 154 patients who had previously attempted suicide and sought medical attention in the emergency department were included in the analysis. Among these patients, 55 individuals (35.7% of the participants) had a documented history of previous suicide attempts. Logistic regression analysis showed that patients with a diagnosed psychiatric disorder were 4.5 times more likely to attempt another suicide compared to those without such a condition (OR = 4.534, p = 0.002). Similarly, patients with a history of illicit drug use were 3.26 times more likely to attempt suicide again than those who reported no substance use (OR = 3.264, p = 0.036). Conclusion: Individuals with a history of suicide attempts are at increased risk of further attempts. This study found that around 36% of people who had previously attempted suicide attempted additional attempts during the study. Moreover, factors such as substance use and a background of psychiatric disorders can predict the likelihood of re-attempting suicide. Suicide R-attempters mental health risk factors Oman. Figures Figure 1 Introduction According to the World Health Organization, there are 800,000 deaths worldwide each year related to suicide, which means that suicide occurs every 40 seconds.[1] Suicide is defined as a deliberate act of self-harm that results in death. [2] Individuals who have previously attempted suicide and seek help in emergency departments (EDs) are at high risk of attempting suicide again [3]. Research has shown that a significant number of people admitted for a suicide attempt repeat the behaviour within a year of admission. [4] For example, a study conducted by Beautrais AL (2004) found that among individuals admitted to an inpatient psychiatric unit for medically serious suicide attempts, 37% made at least one more attempt, and 6.7% eventually died by suicide [5]. In the context of global health, suicide is an important concern due to its association with various risk factors that increase the probability of future suicide attempts. Several factors contribute to an individual's risk of recurrent suicide, including the severity of previous attempts, the chosen method, gender (specifically male), psychiatric history, alcohol abuse, and age.[6–10] However, the discussion of suicide and mental illness in the Arab world is generally considered taboo. Due to this, instances of suicidality are often unreported and are likely significantly underestimated. Recent research indicates that people in the Arab world frequently experience depressive symptoms and have thoughts of suicide. [11] Large-scale studies suggest that suicide rates in the Arab world are relatively low, ranging from 3.9 to 4.8 per 100,000 [12] compared to the global average of 9.0 per 100,000.[13] Oman's suicide rate is also lower than that of most countries, particularly Western societies. However, it remains higher than the rates reported in other Middle Eastern nations such as Iraq [14]. In Oman, intentional self-harm, suicide attempts, and the severity of suicide are often ignored in society due to social stigma, religious beliefs, and cultural influences. This lack of reporting can be attributed to the lack of protocols or resources to accurately document the causes of injuries and deaths. [15] Researchers have identified several risk factors for suicide attempts in Oman, including young age, femininity, history of psychiatric illnesses, history of substance misuse, and presence of psychosocial stressors. The most commonly used method in suicide attempts is drug overdose, with 48.1% of cases involving this method. The primary drug used in these cases is paracetamol (acetaminophen), accounting for 40% of drug overdose attempts [16]. It is crucial to understand the factors that predict suicide among patients who visit emergency departments. These factors can provide information on future suicide attempts and help to develop targeted prevention and intervention strategies. This, in turn, can reduce re-attempts and improve patient outcomes. Research on suicide risk factors and predictors has been carried out around the world. However, no research has been conducted in Oman to investigate these factors among patients who have specifically repeated suicidal attempts. Therefore, the main goal of this study is to determine the rate of subsequent suicide attempts in adults seeking help in the emergency department after their initial suicide attempt. Furthermore, the study aims to explore the clinical and sociodemographic risk factors that could be linked to repeat suicide attempts in adults. Methods This study assessed patients who presented at the emergency department (ED) of Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. It is a retrospective analytic study that uses medical records of patients who visited the emergency department from January 1, 2015, to June 30, 2019. The study included all patients who had suicidal attempts in the emergency department (ED) of SQUH during this time. The study specifically focused on individuals who were referred to psychiatry for evaluation after a suicide attempt. Study process: In all hospitals in Oman, patients who come to the emergency department (ED) are first assessed by experienced nurses in a triage process to determine the urgency of their needs. Subsequently, the patient is evaluated by an emergency physician before being referred to a psychiatrist for further assessment. For this study, we focused on referrals from patients who had attempted suicide and were sent from the Emergency Department to the Department of Behavioural Medicine during the study period. The criteria used in this study to define suicide attempts followed the guidelines outlined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10).[17] During the study period, 2000 patients visited the emergency department and were referred to a psychiatrist for screening. However, 1700 of these referrals were for reasons other than suicide attempts and were therefore excluded from the study. Of the remaining patients, 300 had medical records indicating a suicide attempt. After reviewing the records, 26 patients were found not to have attempted suicide and were excluded. In addition, 120 patients were excluded due to missing dates in their records. Consequently, 154 patients were included in the analysis (Fig. 1). We gathered information from medical records regarding the patient's age, sex, educational level, occupation, marital status and other clinical factors, such as the history of suicide attempts divided into two groups (patients who had made multiple suicide attempts and patients who had attempted suicide for the first time), the presence of mental illness, the presence of medical comorbidities, and alcohol and substance use. Ethical Approval: The College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, approved this study and granted ethical approval (MREC#1653). The study was carried out in accordance with the provisions of the Declaration of Helsinki. Patient informed consent is not required for retrospective chart review and was not sought. Data analysis: Data were analysed using SPSS 23.0 [18]. Descriptive statistics were used to analyse the results of patients who had attempted suicide again and those who had not. Univariate analysis was conducted to evaluate demographic and clinical variables, using a chi-square test and independent t-test to compare the two groups. The logistic regression analysis was then used to determine the variables that were significantly associated with resuicidal attempts (p < 0.05). This analysis aimed to identify the factors contributing to re-suicidal behavior. Results A total of 154 patients were included in the final analysis. Table 1 shows the results for demographic and clinical variables with re-suicidal attempts using univariate and multivariate approaches. A total of 55 subjects (35.7% of the respondents) had re-suicidal attempts. Two-thirds of the participants were women (n = 107, 69.5%), and their mean age was 26.3 (SD = 9.0). Of the 154 participants, 54.5% (n = 84) had a secondary school education level, and more than 42% (n = 65) reported being unemployed. In terms of clinical variables, a significant association was found between mental illness (p < 0.001), having a chronic physical health problem (p < 0.001), and substance use (p = 0.086) and re-suicidal attempts. Regarding demographic variables, no significant association was found with suicidal attempts except for occupation status, which shows a marginal association (p = 0.075). Logistic analysis shows that two clinical variables were significant risk factors for re-suicidal attempts. The model fit well according to the Hosmer-Lemeshow goodness of fit test (chi-square = 3.515, p = 0.742) with an overall prediction power of 68.8%. Patients who had a mental illness were 4.5 times (OR = 4.534, p = 0.002) more likely to have re-suicidal attempts than those without a mental illness. Patients who had a history of substance abuse were 3.26 times (OR = 3.264, p = 0.036) more likely to have re-suicidal attempts than those who reported no substance use. Discussion To our knowledge, this is the first study conducted to identify the risk factors for re-attempted suicide in Oman. In this study, we found that almost 35.7% of suicide attempters re-attempted suicide during the follow-up period. This result is higher than what has been found in the previous literature [19]. In another study, 19% of suicide attempters re-attempted suicide in the following two years [20]. A Danish register-based survival analysis showed that 31.33% of suicide attempters re-attempted suicide within the follow-up period. [21]This study aimed to explore further risk factors for attempted suicide in our population. This study has examined sociodemographic and clinical variables such as gender, age, marital status, educational level, occupation, history of mental illness, chronic disease, and history of substance abuse. Using logistic regression, two clinical variables were significant risk factors for resuicidal attempts, namely past psychiatric illness and a history of substance use. These variables are discussed in the following in conjunction with the background literature. An observational study from Spain found that alcohol use, the presence of personality disorders and younger age were significant risk factors for the re-attempt of suicide [19]. This is consistent with the findings of our study, which showed a significant association between the presence of a psychiatric disorder and substance use and re-attempt. The results of our study did not show any significant association between the risk of reattempting suicide and gender or age, and this finding is consistent with studies conducted elsewhere, which indicated that certain sociodemographic risk factors for suicide might not apply within psychiatric populations. [22] Although the young population, especially adolescents, is regarded a vulnerable group for mental health problems, and youth suicide is considered a significant public health problem, [23] the results of this study did not conclude any significant association between re-attempts and the younger age group. Numerous studies have found a strong link between previous suicide attempts and subsequent re-attempts and have emphasised paying special attention to patients with alcohol problems and physical illness. [24] Furthermore, the presence of chronic diseases is an established risk factor for suicide. It has been hypothesised that the more severe the medical disease, the higher the risk of suicide, even after controlling for mood disorders and alcohol use [25, 26]. This is consistent with the findings of this study and supports the need to screen for suicidality in patients with chronic and severe medical conditions. Furthermore, unemployment is associated with a two- to three-fold increase in the relative risk of death by suicide, and results from systematic reviews and meta-analyses have concluded that long-term unemployment is a significant risk factor for suicide [27, 28]. In this study, unemployment was marginally associated with the risk of re-attempt of suicide. The present study has several limitations that must be acknowledged. First, it is essential to note that there may be some suicide attempts that were not captured in the data because individuals did not seek treatment at the emergency department. Secondly, it appears that this study did not include individuals who died by suicide. Lastly, no follow-up was conducted on individuals who attempted suicide during the study period. Conclusion This study found that 35.7% of people who had attempted suicide had made previous attempts. Those with a history of psychiatric illness were nearly three times more likely to make another attempt, as were those with a history of substance use. To establish a cause-and-effect relationship between risk factors and suicide, additional longitudinal follow-up studies focussing on identifying and moderating risk factors are needed. Although it is not possible to accurately predict suicide, we can still identify a significant number of individuals who are at risk. By implementing preventive measures against depression throughout the general population through a range of interventions at various levels of the healthcare system, we can effectively implement policies for suicide prevention strategies. References Suicide: one person dies every 40 seconds. https://www.who.int/news/item/09-09-2019-suicide-one-person-dies-every-40-seconds. Accessed 10 Jun 2024 Murphy SL (2000) Deaths: final data for 1998. Natl Vital Stat Rep Cent Dis Control Prev Natl Cent Health Stat Natl Vital Stat Syst 48:1–105 (2022) Psychiatric Hospitalization for Attempted Suicide and Reattempt at the One-Year Follow-Up. Psicothema 34 3:375–382 (2022) Suicide-related crisis presentations to a rural emergency department: A retrospective cohort study. Australas Psychiatry 31:13–18 Beautrais AL (2004) Further suicidal behavior among medically serious suicide attempters. Suicide Life Threat Behav 34:1–11 Olfson M, Wall M, Wang S, Crystal S, Gerhard T, Blanco C (2017) Suicide Following Deliberate Self-Harm. Am J Psychiatry 174:765–774 Olfson M, Wall M, Wang S, Crystal S, Liu S-M, Gerhard T, Blanco C (2016) Short-term Suicide Risk After Psychiatric Hospital Discharge. JAMA Psychiatry 73:1119 Goldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M (2019) Association of Suicide and Other Mortality With Emergency Department Presentation. JAMA Netw Open 2:e1917571 Chesney E, Goodwin GM, Fazel S (2014) Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 13:153–160 Chakravarthy B, Hoonpongsimanont W, Anderson C, Habicht M, Bruckner T, Lotfipour S (2014) Depression, Suicidal Ideation, and Suicidal Attempt Presenting to the Emergency Department: Differences Between These Cohorts. West J Emerg Med 15:211–216 Fayyaz N, Beg R Systematic review and meta analysis of major depression and suicidal ideation among University students in the Middle East. Middle East North Afr Sci 2019;5:1–5. Naghavi M, Global Burden of Disease Self-Harm Collaborators (2019) Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ 364:l94 Suicide worldwide in 2019. https://www.who.int/publications-detail-redirect/9789240026643. Accessed 8 Jun 2024 Younis MS, Lafta RK (2023) Suicide and suicidality in Iraq: a systematic review. Med Confl Surviv 39:48–62 Al-Adawi S, Al-Huseini S, Shetty M, Al-Abdali H, Ganesh A, Al-Sibani N (2024) Suicidal Behaviour in Oman: Emerging Trends and Challenges. In: Arafat SMY, Rezaeian M, Khan MM (eds) Suicidal Behav. Muslim Major. Ctries. Epidemiol. Risk Factors Prev. Springer Nature, Singapore, pp 207–222 Al Khatri M, Al Huseini S, Almaqbali M, Cucchi A, Al Saadi A-K, Al Farsi A, Jose S, Al-Sibani N, Al-Adawi S (2023) Sociodemographic Characteristics and Clinical Profile of Suicide Attempters Attending the Emergency Department at a Tertiary Care Hospital in Oman: A Retrospective Study. J Psychiatr Pract 29:390–402 (2022) Recurrence of Overdose Suicide Attempt index: a novel scoring system for predicting the recurrence of intentional overdose. 84:301–310 SPSS Software | IBM. https://www.ibm.com/spss?utm_content=SRCWW&p1=Search&p4=43700077577385080&p5=p&p9=58700008510998194&gad_source=1& gclid=CjwKCAjwyJqzBhBaEiwAWDRJVJicgfsyu8wI2iH27Mg2NOIAFVA_CSqYxbFdxTO8E8u2lH0fIknNAhoCfloQAvD_BwE&gclsrc=aw.ds. Accessed 10 Jun 2024 Parra-Uribe I, Blasco-Fontecilla H, Garcia-Parés G, Martínez-Naval L, Valero-Coppin O, Cebrià-Meca A, Oquendo MA, Palao-Vidal D (2017) Risk of re-attempts and suicide death after a suicide attempt: A survival analysis. BMC Psychiatry 17:163 Irigoyen M, Porras-Segovia A, Galván L, Puigdevall M, Giner L, De Leon S, Baca-García E (2019) Predictors of re-attempt in a cohort of suicide attempters: A survival analysis. J Affect Disord 247:20–28 Christiansen E, Frank Jensen B (2007) Risk of Repetition of Suicide Attempt, Suicide or all Deaths after an Episode of Attempted Suicide: A Register-Based Survival Analysis. Aust N Z J Psychiatry 41:257–265 Bhatt M, Perera S, Zielinski L, et al (2018) Profile of suicide attempts and risk factors among psychiatric patients: A case-control study. PLOS ONE 13:e0192998 Bilsen J (2018) Suicide and Youth: Risk Factors. Front Psychiatry. https://doi.org/10.3389/fpsyt.2018.00540 Cooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway-Jones K, Appleby L (2005) Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 162:297–303 Hirsch JK, Duberstein PR, Unützer J (2009) Chronic medical problems and distressful thoughts of suicide in primary care patients: mitigating role of happiness. Int J Geriatr Psychiatry 24:671–679 Druss B, Pincus H (2000) Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med 160:1522–1526 Milner A, Page A, LaMontagne AD (2013) Long-term unemployment and suicide: a systematic review and meta-analysis. PloS One 8:e51333 Blakely T, Collings S, Atkinson J (2003) Unemployment and suicide. Evidence for a causal association? J Epidemiol Community Health 57:594–600 Tables Univariate and multivariate analysis (logistic regression) for repetitive suicide attempts in relation to demographic and clinical measures. Variables suicidal attempt Univariate analysis Multivariate analysis^ Total (n=154) First time (n=55) Repetitive suicide attempts (n=99) n (%) n (%) n (%) Statistics p -value Statistics p -value Demographic sex Men 47 (30.5) 20 (36.4) 27 (27.3) 1.524 a 0.240 Women 107 (69.5) 35 (63.6) 72 (72.7) Civil status Not married (Single, Divorced and Widow) 97 (63.0) 36 (65.5) 61 (61.6) 1.693 0.429 Married 57 (37.0) 19 (34.5) 38 (38.4) Work Unemployed 65 (42.2) 29 (52.7) 36 (36.4) 5.167 0.075 1.623 a 0.323 Employed 43 (27.9) 10 (18.2) 33 (33.3) 0.699 a 0.457 Student 46 (29.9) 16 (29.1) 30 (30.3) 1 Educational Qualification Undergraduate 39 (25.3) 14 (25.5) 25 (25.3) 0.731 0.694 Secondary education. 84 (54.5) 28 (50.9) 56 (56.6) Higher education 31 (20.1) 13 (23.6) 18 (18.2) Age Mean ± SD 26.3 ± 9.0 26.5 ± 7.1 26.2 ± 10.0 0.211 b 0.833 Clinical Mental illness Yes 63 (40.9) 36 (65.5) 27 (27.3) 5.053 a <.001 4.534 a 0.002 No 91 (59.1) 19 (34.5) 72 (72.7) Substance misused Yes 21 (13.6) 11 (20.0) 10 (10.1) 2.225 a 0.086 3.263 a 0.036 No 133 (86.4) 44 (80.0) 89 (89.9) Alcohol used. Yes 21 (13.6) 9 (16.4) 12 (12.1) 1.418 a 0.462 No 133 (86.4) 46 (83.6) 87 (87.9) Physical health. Chronic disease 41 (26.6) 24 (43.6) 17 (17.2) 3.734 a <.001 1.650 a 0.304 No chronic disease 113 (73.4) 31 (56.4) 82 (82.8) a, odds ratio; b, Independent t-test, |t|-statistics; c, Fisher's exact test ^, Enter; Hosmer and Lemeshow Test; chi-square=3.515, p=0.742; Cox & Snell R square = 0.175; Sensitivity=72.7%, Specificity=66.7%, overall predicting power=68.8% . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4578008","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":322036073,"identity":"d695c211-0ad4-496f-832e-d0dab7751498","order_by":0,"name":"Salim 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attempting suicide\u0026nbsp;again [3].\u0026nbsp;Research has shown that a significant number of\u0026nbsp;people\u0026nbsp;admitted for a suicide attempt repeat the\u0026nbsp;behaviour\u0026nbsp;within a year of\u0026nbsp;admission.\u0026nbsp;[4]\u0026nbsp;For\u0026nbsp;example,\u0026nbsp;a study conducted by Beautrais AL (2004) found that among individuals admitted to an inpatient psychiatric unit for medically serious suicide attempts, 37% made at least one more attempt, and 6.7% eventually died by\u0026nbsp;suicide [5].\u0026nbsp;In the context of global health, suicide is\u0026nbsp;an important\u0026nbsp;concern due to its association with various risk factors that increase the\u0026nbsp;probability\u0026nbsp;of future suicide attempts. Several factors contribute to an individual\u0026apos;s risk of recurrent suicide, including the severity of previous attempts, the chosen method, gender (specifically male), psychiatric history, alcohol abuse, and age.[6\u0026ndash;10]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever,\u0026nbsp;the discussion of\u0026nbsp;suicide and mental illness in the Arab\u0026nbsp;world\u0026nbsp;is generally considered taboo.\u0026nbsp;Due to\u0026nbsp;this, instances of suicidality are often unreported\u0026nbsp;and are\u0026nbsp;likely significantly underestimated. Recent research indicates that\u0026nbsp;people\u0026nbsp;in the Arab\u0026nbsp;world\u0026nbsp;frequently experience depressive symptoms and have thoughts of\u0026nbsp;suicide. [11]\u0026nbsp;Large-scale studies suggest that suicide rates in the Arab\u0026nbsp;world\u0026nbsp;are relatively low, ranging from 3.9 to 4.8 per 100,000\u0026nbsp;[12]\u0026nbsp;compared to the global average of 9.0 per 100,000.[13]\u0026nbsp; Oman\u0026apos;s suicide rate is also lower than that of most countries, particularly Western societies.\u0026nbsp;However,\u0026nbsp;it remains higher\u0026nbsp;than the\u0026nbsp;rates reported in other Middle Eastern nations such as\u0026nbsp;Iraq [14]. In\u0026nbsp;Oman, intentional self-harm, suicide attempts, and the severity of\u0026nbsp;suicide are\u0026nbsp;often\u0026nbsp;ignored\u0026nbsp;in society due to social stigma, religious beliefs, and cultural influences. This lack of reporting can be attributed to the\u0026nbsp;lack\u0026nbsp;of protocols or resources\u0026nbsp;to accurately\u0026nbsp;document the causes of injuries and\u0026nbsp;deaths. [15]\u0026nbsp;Researchers have identified several risk factors for suicide attempts in Oman, including young age, femininity, history of psychiatric illnesses, history of substance misuse, and presence of psychosocial stressors. The\u0026nbsp;most commonly\u0026nbsp;used method in suicide attempts is drug overdose, with 48.1% of cases involving this method. The primary drug used in these cases is paracetamol (acetaminophen), accounting for 40% of drug overdose\u0026nbsp;attempts [16].\u003c/p\u003e\n\u003cp\u003eIt is crucial to understand the factors that predict suicide among patients who visit emergency departments. These factors can provide\u0026nbsp;information on\u0026nbsp;future suicide attempts and help\u0026nbsp;to develop\u0026nbsp;targeted prevention and intervention strategies. This, in turn, can reduce re-attempts and improve patient outcomes. Research on suicide risk factors and predictors has been\u0026nbsp;carried out around the world.\u0026nbsp;However,\u0026nbsp;no research has\u0026nbsp;been\u0026nbsp;conducted in Oman to investigate these factors among patients who\u0026nbsp;have specifically\u0026nbsp;repeated suicidal\u0026nbsp;attempts.\u0026nbsp;Therefore, the main goal of this study is to determine the rate of subsequent suicide attempts in adults\u0026nbsp;seeking\u0026nbsp;help\u0026nbsp;in\u0026nbsp;the emergency department\u0026nbsp;after\u0026nbsp;their initial suicide attempt.\u0026nbsp;Furthermore,\u0026nbsp;the study aims to explore the clinical and\u0026nbsp;sociodemographic\u0026nbsp;risk factors that\u0026nbsp;could\u0026nbsp;be linked to repeat suicide attempts in adults.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study assessed patients who presented at the emergency department (ED) of Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. It is a retrospective analytic study that\u0026nbsp;uses\u0026nbsp;medical records of patients who visited the\u0026nbsp;emergency department\u0026nbsp;from January 1, 2015, to June 30, 2019. The study included all patients who\u0026nbsp;had\u0026nbsp;suicidal attempts\u0026nbsp;in\u0026nbsp;the emergency department (ED) of SQUH during this time. The study specifically focused on individuals who were referred to psychiatry for evaluation\u0026nbsp;after\u0026nbsp;a suicide attempt.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy process:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn all hospitals in Oman, patients who come to the emergency department (ED) are first assessed by experienced nurses in a triage process to determine the urgency of their needs.\u0026nbsp;Subsequently,\u0026nbsp;the patient is evaluated by an emergency physician before being referred to a psychiatrist for further assessment. For this study, we focused\u0026nbsp;on\u0026nbsp;referrals\u0026nbsp;from\u0026nbsp;patients who had attempted suicide and were sent from the\u0026nbsp;Emergency Department\u0026nbsp;to the Department of\u0026nbsp;Behavioural\u0026nbsp;Medicine during the study period. The criteria used in this study to define suicide attempts followed the guidelines outlined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10).[17]\u003c/p\u003e\n\u003cp\u003eDuring the study period, 2000 patients visited the emergency department and were referred to a psychiatrist for screening. However, 1700 of these referrals were for reasons other than suicide attempts and were therefore excluded from the study.\u0026nbsp;Of\u0026nbsp;the remaining patients, 300 had medical records indicating a suicide attempt. After reviewing the records, 26 patients were found not to have attempted suicide and were excluded.\u0026nbsp;In addition,\u0026nbsp;120 patients were excluded due to missing dates in their records. Consequently, 154 patients were included in the analysis (Fig. 1).\u003c/p\u003e\n\u003cp\u003eWe gathered information\u0026nbsp;from\u0026nbsp;medical records regarding the patient\u0026apos;s age, sex, educational level, occupation, marital\u0026nbsp;status\u0026nbsp;and other clinical factors, such as the history of suicide attempts divided into two groups (patients who had made multiple suicide attempts and patients who had attempted suicide for the first time), the presence of mental illness, the presence of medical comorbidities, and alcohol and substance use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, approved this study and granted ethical approval (MREC#1653). The study was\u0026nbsp;carried out in accordance with\u0026nbsp;the provisions of the Declaration of Helsinki. Patient informed consent is not required for retrospective chart review and was not sought.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData were analysed using SPSS 23.0 [18]. Descriptive statistics were used to analyse the results of patients who had attempted suicide again and those who had not. Univariate analysis was conducted to evaluate demographic and clinical variables, using a chi-square test and independent t-test to compare the two groups. The logistic regression analysis was then used to determine the variables that were significantly associated with resuicidal attempts (p \u0026lt; 0.05). This analysis aimed to identify the factors contributing to re-suicidal behavior.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 154 patients were included in the final analysis. Table 1 shows the results for demographic and clinical variables with re-suicidal attempts using univariate and multivariate approaches. A total of 55 subjects (35.7% of the respondents) had re-suicidal attempts. Two-thirds of the participants were\u0026nbsp;women\u0026nbsp;(n = 107, 69.5%), and their\u0026nbsp;mean\u0026nbsp;age was 26.3 (SD = 9.0). Of the 154 participants, 54.5% (n = 84) had a secondary school education level, and more than 42% (n = 65) reported being unemployed. In terms of clinical variables, a significant association was found between mental illness (p \u0026lt; 0.001), having a chronic physical health problem (p \u0026lt; 0.001), and substance use (p = 0.086) and re-suicidal attempts.\u0026nbsp;Regarding\u0026nbsp;demographic variables, no significant association was\u0026nbsp;found with suicidal\u0026nbsp;attempts except for occupation status, which shows a marginal association (p = 0.075).\u003c/p\u003e\n\u003cp\u003eLogistic analysis shows that two clinical variables were significant risk factors for re-suicidal attempts. The model fit well according to the Hosmer-Lemeshow goodness of fit test (chi-square = 3.515, p = 0.742) with an overall prediction power of 68.8%. Patients who had a mental illness were 4.5 times (OR = 4.534, p = 0.002) more likely to have re-suicidal attempts than those without a mental illness. Patients who had a history of substance abuse were 3.26 times (OR = 3.264, p = 0.036) more likely to have re-suicidal attempts than those who reported no substance use.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo our knowledge, this is the first study conducted to identify the risk factors for re-attempted suicide in Oman. In this study, we found that almost 35.7% of suicide attempters re-attempted suicide during the follow-up period. This result is higher than what has been found\u0026nbsp;in the\u0026nbsp;previous\u0026nbsp;literature [19].\u0026nbsp;In another study, 19% of suicide attempters re-attempted suicide in the following two\u0026nbsp;years [20].\u0026nbsp;A Danish register-based survival analysis showed that 31.33% of suicide attempters re-attempted suicide within the follow-up period.\u0026nbsp;[21]This study aimed to explore further risk factors for attempted suicide in our population. This study has examined\u0026nbsp;sociodemographic\u0026nbsp;and clinical variables\u0026nbsp;such as\u0026nbsp;gender, age, marital status, educational level, occupation, history of mental illness, chronic disease, and history of substance abuse.\u0026nbsp;Using\u0026nbsp;logistic regression, two clinical variables were significant risk factors for\u0026nbsp;resuicidal\u0026nbsp;attempts, namely past psychiatric illness and a history of substance use. These variables are\u0026nbsp;discussed\u0026nbsp;in\u0026nbsp;the following in conjunction\u0026nbsp;with the background literature. An observational study from Spain found that\u0026nbsp;alcohol use,\u0026nbsp;the presence of personality\u0026nbsp;disorders\u0026nbsp;and younger age were significant risk factors\u0026nbsp;for the re-attempt of\u0026nbsp;suicide\u0026nbsp;[19].\u0026nbsp;This is\u0026nbsp;consistent\u0026nbsp;with the findings of our study, which showed a significant association between the presence of a psychiatric disorder and substance use and\u0026nbsp;re-attempt.\u0026nbsp;The results of our study did not show any significant association between the risk of\u0026nbsp;reattempting\u0026nbsp;suicide and gender or age, and this finding is consistent with studies conducted elsewhere, which indicated that certain\u0026nbsp;sociodemographic\u0026nbsp;risk factors for suicide might not apply within psychiatric populations.\u0026nbsp;[22]\u0026nbsp;Although the young population, especially\u0026nbsp;adolescents, is regarded\u0026nbsp;a vulnerable group for mental health\u0026nbsp;problems,\u0026nbsp;and youth suicide is considered a significant public health problem,\u0026nbsp;[23]\u0026nbsp;the results of this study did not conclude any significant association between re-attempts and the younger age group. Numerous studies have found a strong link between previous suicide attempts and subsequent re-attempts and have\u0026nbsp;emphasised\u0026nbsp;paying special attention to patients with alcohol problems and physical illness.\u0026nbsp;[24]\u003c/p\u003e\n\u003cp\u003eFurthermore,\u0026nbsp;the presence of chronic\u0026nbsp;diseases\u0026nbsp;is an established risk factor for suicide. It has been\u0026nbsp;hypothesised\u0026nbsp;that the more severe the medical disease, the higher the risk of suicide, even after controlling for mood disorders and alcohol\u0026nbsp;use [25, 26].\u0026nbsp;This is\u0026nbsp;consistent\u0026nbsp;with the findings of this study and supports the need to screen for suicidality in patients with chronic and severe medical conditions. Furthermore, unemployment is associated with a\u0026nbsp;two-\u0026nbsp;to three-fold\u0026nbsp;increase in the\u0026nbsp;relative risk of death by suicide, and results from systematic reviews and meta-analyses have concluded that long-term unemployment is a significant risk factor for\u0026nbsp;suicide [27, 28].\u0026nbsp;In this study, unemployment was marginally associated with the risk of\u0026nbsp;re-attempt of suicide.\u003c/p\u003e\n\u003cp\u003eThe present study has several limitations that must be acknowledged. First, it is essential to note that there may be some suicide attempts that were not captured in the data because individuals did not seek treatment at the emergency department. Secondly, it appears that this study did not include individuals who died by suicide. Lastly, no follow-up was conducted on individuals who attempted suicide during the study period.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study found that 35.7% of people who had attempted suicide had made previous attempts. Those with a history of psychiatric illness were nearly three times more likely to make another attempt, as were those with a history of substance use. To establish a cause-and-effect relationship between risk factors and suicide, additional longitudinal follow-up studies focussing on identifying and moderating risk factors are needed. Although it is not possible to accurately predict suicide, we can still identify a significant number of individuals who are at risk. By implementing preventive measures against depression throughout the general population through a range of interventions at various levels of the healthcare system, we can effectively implement policies for suicide prevention strategies.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSuicide: one person dies every 40 seconds. https://www.who.int/news/item/09-09-2019-suicide-one-person-dies-every-40-seconds. Accessed 10 Jun 2024\u003c/li\u003e\n\u003cli\u003eMurphy SL (2000) Deaths: final data for 1998. Natl Vital Stat Rep Cent Dis Control Prev Natl Cent Health Stat Natl Vital Stat Syst 48:1\u0026ndash;105\u003c/li\u003e\n\u003cli\u003e(2022) Psychiatric Hospitalization for Attempted Suicide and Reattempt at the One-Year Follow-Up. Psicothema 34 3:375\u0026ndash;382\u003c/li\u003e\n\u003cli\u003e(2022) Suicide-related crisis presentations to a rural emergency department: A retrospective cohort study. Australas Psychiatry 31:13\u0026ndash;18\u003c/li\u003e\n\u003cli\u003eBeautrais AL (2004) Further suicidal behavior among medically serious suicide attempters. Suicide Life Threat Behav 34:1\u0026ndash;11\u003c/li\u003e\n\u003cli\u003eOlfson M, Wall M, Wang S, Crystal S, Gerhard T, Blanco C (2017) Suicide Following Deliberate Self-Harm. Am J Psychiatry 174:765\u0026ndash;774\u003c/li\u003e\n\u003cli\u003eOlfson M, Wall M, Wang S, Crystal S, Liu S-M, Gerhard T, Blanco C (2016) Short-term Suicide Risk After Psychiatric Hospital Discharge. JAMA Psychiatry 73:1119\u003c/li\u003e\n\u003cli\u003eGoldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M (2019) Association of Suicide and Other Mortality With Emergency Department Presentation. JAMA Netw Open 2:e1917571\u003c/li\u003e\n\u003cli\u003eChesney E, Goodwin GM, Fazel S (2014) Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 13:153\u0026ndash;160\u003c/li\u003e\n\u003cli\u003eChakravarthy B, Hoonpongsimanont W, Anderson C, Habicht M, Bruckner T, Lotfipour S (2014) Depression, Suicidal Ideation, and Suicidal Attempt Presenting to the Emergency Department: Differences Between These Cohorts. West J Emerg Med 15:211\u0026ndash;216\u003c/li\u003e\n\u003cli\u003eFayyaz N, Beg R Systematic review and meta analysis of major depression and suicidal ideation among University students in the Middle East. Middle East North Afr Sci 2019;5:1\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eNaghavi M, Global Burden of Disease Self-Harm Collaborators (2019) Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ 364:l94\u003c/li\u003e\n\u003cli\u003eSuicide worldwide in 2019. https://www.who.int/publications-detail-redirect/9789240026643. Accessed 8 Jun 2024\u003c/li\u003e\n\u003cli\u003eYounis MS, Lafta RK (2023) Suicide and suicidality in Iraq: a systematic review. Med Confl Surviv 39:48\u0026ndash;62\u003c/li\u003e\n\u003cli\u003eAl-Adawi S, Al-Huseini S, Shetty M, Al-Abdali H, Ganesh A, Al-Sibani N (2024) Suicidal Behaviour in Oman: Emerging Trends and Challenges. In: Arafat SMY, Rezaeian M, Khan MM (eds) Suicidal Behav. Muslim Major. Ctries. Epidemiol. Risk Factors Prev. Springer Nature, Singapore, pp 207\u0026ndash;222\u003c/li\u003e\n\u003cli\u003eAl Khatri M, Al Huseini S, Almaqbali M, Cucchi A, Al Saadi A-K, Al Farsi A, Jose S, Al-Sibani N, Al-Adawi S (2023) Sociodemographic Characteristics and Clinical Profile of Suicide Attempters Attending the Emergency Department at a Tertiary Care Hospital in Oman: A Retrospective Study. J Psychiatr Pract 29:390\u0026ndash;402\u003c/li\u003e\n\u003cli\u003e(2022) Recurrence of Overdose Suicide Attempt index: a novel scoring system for predicting the recurrence of intentional overdose. 84:301\u0026ndash;310\u003c/li\u003e\n\u003cli\u003eSPSS Software | IBM. https://www.ibm.com/spss?utm_content=SRCWW\u0026amp;p1=Search\u0026amp;p4=43700077577385080\u0026amp;p5=p\u0026amp;p9=58700008510998194\u0026amp;gad_source=1\u0026amp; gclid=CjwKCAjwyJqzBhBaEiwAWDRJVJicgfsyu8wI2iH27Mg2NOIAFVA_CSqYxbFdxTO8E8u2lH0fIknNAhoCfloQAvD_BwE\u0026amp;gclsrc=aw.ds. Accessed 10 Jun 2024\u003c/li\u003e\n\u003cli\u003eParra-Uribe I, Blasco-Fontecilla H, Garcia-Par\u0026eacute;s G, Mart\u0026iacute;nez-Naval L, Valero-Coppin O, Cebri\u0026agrave;-Meca A, Oquendo MA, Palao-Vidal D (2017) Risk of re-attempts and suicide death after a suicide attempt: A survival analysis. BMC Psychiatry 17:163\u003c/li\u003e\n\u003cli\u003eIrigoyen M, Porras-Segovia A, Galv\u0026aacute;n L, Puigdevall M, Giner L, De Leon S, Baca-Garc\u0026iacute;a E (2019) Predictors of re-attempt in a cohort of suicide attempters: A survival analysis. J Affect Disord 247:20\u0026ndash;28\u003c/li\u003e\n\u003cli\u003eChristiansen E, Frank Jensen B (2007) Risk of Repetition of Suicide Attempt, Suicide or all Deaths after an Episode of Attempted Suicide: A Register-Based Survival Analysis. Aust N Z J Psychiatry 41:257\u0026ndash;265\u003c/li\u003e\n\u003cli\u003eBhatt M, Perera S, Zielinski L, et al (2018) Profile of suicide attempts and risk factors among psychiatric patients: A case-control study. PLOS ONE 13:e0192998\u003c/li\u003e\n\u003cli\u003eBilsen J (2018) Suicide and Youth: Risk Factors. Front Psychiatry. https://doi.org/10.3389/fpsyt.2018.00540\u003c/li\u003e\n\u003cli\u003eCooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway-Jones K, Appleby L (2005) Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 162:297\u0026ndash;303\u003c/li\u003e\n\u003cli\u003eHirsch JK, Duberstein PR, Un\u0026uuml;tzer J (2009) Chronic medical problems and distressful thoughts of suicide in primary care patients: mitigating role of happiness. Int J Geriatr Psychiatry 24:671\u0026ndash;679\u003c/li\u003e\n\u003cli\u003eDruss B, Pincus H (2000) Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med 160:1522\u0026ndash;1526\u003c/li\u003e\n\u003cli\u003eMilner A, Page A, LaMontagne AD (2013) Long-term unemployment and suicide: a systematic review and meta-analysis. PloS One 8:e51333\u003c/li\u003e\n\u003cli\u003eBlakely T, Collings S, Atkinson J (2003) Unemployment and suicide. Evidence for a causal association? J Epidemiol Community Health 57:594\u0026ndash;600\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"720\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"8\" valign=\"top\" style=\"width: 66.346%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003emultivariate analysis (logistic regression)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;for repetitive suicide attempts in\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003erelation\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;to\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003edemographic\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eclinical measures.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.02777777777778%\" rowspan=\"3\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.805555555555555%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"22.083333333333332%\" colspan=\"2\" valign=\"top\" style=\"width: 21.2056%;\"\u003e\n \u003cp\u003e\u003cstrong\u003esuicidal attempt\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.444444444444443%\" colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 9.8174%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.72222222222222%\" colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 9.8174%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate analysis^\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"32.075471698113205%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n=154)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.30188679245283%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eFirst time\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=55)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.69811320754717%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRepetitive suicide attempts\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=99)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"15.510948905109489%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.686131386861314%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.328467153284672%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.86861313868613%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.678832116788321%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.86861313868613%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatistics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.226277372262773%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDemographic\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003esex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eMen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e47 (30.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e20 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e27 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1.524\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eWomen\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e107 (69.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e35 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e72 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCivil status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eNot married (Single, Divorced and Widow)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e97 (63.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e36 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e61 (61.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1.693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e57 (37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e19 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e38 (38.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWork\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e65 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e29 (52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e36 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e5.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1.623\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e43 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e10 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e33 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e0.699\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e0.457\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e46 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e16 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e30 (30.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational Qualification\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e39 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e14 (25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e25 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e0.731\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.694\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eSecondary\u0026nbsp;education.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e84 (54.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e28 (50.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e56 (56.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eHigher education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e31 (20.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e13 (23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e18 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e26.3 \u0026plusmn; 9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e26.5 \u0026plusmn; 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e26.2 \u0026plusmn; 10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e0.211\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMental illness\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e63 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e36 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e27 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e5.053\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e4.534\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e91 (59.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e19 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e72 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubstance misused\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e21 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e11 (20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e10 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e2.225\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e3.263\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e133 (86.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e44 (80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e89 (89.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol used.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e21 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e9 (16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e12 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1.418\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e0.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e133 (86.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e46 (83.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e87 (87.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical health.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eChronic disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e41 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e24 (43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e17 (17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e3.734\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\n \u003cp\u003e1.650\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.994452149791954%\" valign=\"top\" style=\"width: 15.3151%;\"\u003e\n \u003cp\u003eNo chronic disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.789181692094314%\" valign=\"top\" style=\"width: 13.9407%;\"\u003e\n \u003cp\u003e113 (73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.402219140083218%\" valign=\"top\" style=\"width: 12.2717%;\"\u003e\n \u003cp\u003e31 (56.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.650485436893204%\" valign=\"top\" style=\"width: 8.9338%;\"\u003e\n \u003cp\u003e82 (82.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"8.876560332871012%\" valign=\"top\" style=\"width: 3.7306%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.540915395284328%\" valign=\"top\" style=\"width: 6.0868%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.29264909847434%\" valign=\"top\" style=\"width: 3.6324%;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"8\" valign=\"top\" style=\"width: 70.5871%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ea, odds ratio; b, Independent t-test, |t|-statistics; c, Fisher\u0026apos;s exact test\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e^, Enter; Hosmer and Lemeshow Test; chi-square=3.515, p=0.742; Cox \u0026amp; Snell R\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003esquare\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;= 0.175; Sensitivity=72.7%, Specificity=66.7%, overall predicting power=68.8%\u003c/strong\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Suicide R-attempters, mental health, risk factors, Oman.","lastPublishedDoi":"10.21203/rs.3.rs-4578008/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4578008/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e \u0026nbsp;This study aims to determine the rate of re-attempted suicide among individuals with a prior history of suicidal attempts. Additionally, it seeks to identify factors that could potentially predict future suicide re-attempts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e We retrospectively collected medical data on patients under 18 years of age who were admitted to our emergency department after attempting suicide. We evaluated the general characteristics of the patients. We divided them into two groups: patients who had made multiple suicide attempts and patients who attempted suicide for the first time. Logistic regression analysis was performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e A total of 154 patients who had previously attempted suicide and sought medical attention in the emergency department were included in the analysis. Among these patients, 55 individuals (35.7% of the participants) had a documented history of previous suicide attempts. Logistic regression analysis showed that patients with a diagnosed psychiatric disorder were 4.5 times more likely to attempt another suicide compared to those without such a condition (OR = 4.534, p = 0.002). Similarly, patients with a history of illicit drug use were 3.26 times more likely to attempt suicide again than those who reported no substance use (OR = 3.264, p = 0.036).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eIndividuals with a history of suicide attempts are at increased risk of further attempts. This study found that around 36% of people who had previously attempted suicide attempted additional attempts during the study. Moreover, factors such as substance use and a background of psychiatric disorders can predict the likelihood of re-attempting suicide.\u003c/p\u003e","manuscriptTitle":"Prevalence and associated factors of a repeat of suicide attempt among individuals attending an emergency department in Oman.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-12 15:13:51","doi":"10.21203/rs.3.rs-4578008/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"468e0e1b-6b1c-4ebf-b699-b0b439014dcc","owner":[],"postedDate":"July 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-12T15:13:51+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-12 15:13:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4578008","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4578008","identity":"rs-4578008","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}