Suicidality and social cognition: the association between hypomentalizing and suicide lethality.

Introduction: Suicide attempts (SA) leading to highly lethal consequences have been associated with heightened suicide planning (Barker et al., 2022), along with deficits in social cognition (Levi-Belz et al., 2022). Hypomentalizing, characterized by excessive uncertainty regarding mental states, may contribute to heightened social withdrawal and an increased risk of SA (Nestor & Sutherland, 2022). Although certain studies have identified a connection between hypomentalizing profiles and self-harm (Badoud et al., 2015), research into the lethality of SA remains limited. Objectives: This study aimed to explore the association between hypomentalizing and SA lethality. Methods: Our study encompassed a cohort of 1,371 patients who committed a SA. We conducted assessments of mentalizing using the RFQ-8 instrument, and evaluations of suicidal ideation and behavior employing the CSRSS questionnaire. Demographic and clinical characteristics were compared using the T-student and Chi-square tests. To investigate the relationship between hypomentalizing and the SA lethality, we employed logistic regression models. Results: Descriptive date are presented in Table 1. Our results show that hypomentalizing do not predict a higher SA lethality. Additionally, hypomentalizing increased the risk of SA planning (p≤0.001, B=-0.182), and SA planning predicted a higher SA lethality (see Table 2). Table 1. Means Comparison for low and high lethality (N=1371) Low lethality N=539 High lethality N=832 p value Effect size Age, mean (SD) 38.65 (15.65) 41.91 (15.37) ≤0.001 -0.209^a Female sex, N (%) 392 (72.7) 571 (68.6) 0.116 0.044^b Educational years, mean (SD) 12.45 (2.99) 12.43 (3.41) 0.890 0.0076^a Employed, N (%) 220 (41.2) 332 (40) 0.692 0.012^b Suicide Ideation, N (%) 475 (88.1) 742 (89.2) 0.541 0.016^b Suicide Planning, N (%) 159 (39.2) 400 (58.1) ≤0.001 0.183^b Number of attempts, mean (SD) 3.28 (5.48) 3.63 (5.74) 0.269 -0.169^a RFQ, mean (SD) 4.68 (1.27) 4.56 (1.32) 0.087 0.095^a Table 2. Logistic regression analyses for high SA lethality (N=1371). Univariate analysis Multivariate analysis OR p value OR p value Age 1.014 (1.007-1.021) ≤0.001 1.014 (1.005-1.022) 0.001 Female sex 0.820 (0.646-1.042) 0.105 Educational years 0.998 (0.965-1.031) 0.890 Employed 0.952 (0.763-1.187) 0.660 Suicide ideation 1.111 (0.790-1.562) 0.545 Suicide planning 2.150 (1.674-2.761) ≤0.001 2.183 (1.697-2.808) ≤0.001 Number SA 1.012 (0.990-1.034) 0.277 RFQ 0.929 (0.854-1.011) 0.088 Conclusions: While the association between hypomentalizing and high SA lethality was not significant, a discernible trend toward such relationship can be noted. Further studies examining the moderating effects of planning in the association between hypomentalizing and SA lethality are required. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]