Search

IntroductionConcerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic.ObjectivesTo investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this.MethodsSample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model.ResultsSample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).Multivariable binary logistic regression model on ‘user’ as outcomeβSEWaldpOR95% CIAge-0.0750.0383.9100.0480.9280.861-0.999Education level-0.9671.2890.5630.4530.3800.030-4.755Early adolescence premorbid adjustment-0.2850.1106.6950.0100.7520.606-0.933Trail Making Test A-0.0300.0251.4880.2220.9700.924-1.018Trail Making Test B-0.0050.0100.2780.5980.9950.976-1.014Cognitive Insight0.0620.0611.0430.3071.0640.944-1.200X2=25.296,df=6,p2=44.7%. Correctly classified: 76.9%, users:54.5%, non-users:88.4%.ConclusionsAcceptability of a smartphone-based EMA application among SSD patients was low. Age (young) and good premorbid adjustment predicted acceptability. e-Mental Health methods need to be tailored for patients with SSD. Otherwise, these highly vulnerable individuals may be neglected by e-health-based services in the post-COVID-19 years ahead.

BackgroundOptimizing psychiatric assessments could help to standardize the use of structured instruments in clinical practice. In recent years, several research groups have applied Computerized Adaptive Tests (CATs) to simplify assessments in depression, anxiety and also suicidal behaviors. We aimed to construct a shortened test to classify suicide attempters using a decision tree methodology that allows the integration of relevant clinical information, namely the history of past suicide attempts, in the construction of the test.MethodsThe sample was composed of 902 adult participants in three subsamples: first-time suicide attempters, psychiatric inpatients that never attempted suicide and healthy controls. The performance of a decision tree built using the items of a previously developed scale for suicidal risk was examined. The history of past suicide attempts was used to separate patients in the decision tree. The data was randomly divided in a training set and a test set. The test set, that contained 25% of the data, was used to determine the accuracy of the decision tree. Twenty-five cross-validations of this set up were conducted.ResultsThe first four items of the decision tree classified correctly 81.4% of the patients.ConclusionAs a result of a methodology based on decision trees that, contrary to CATs, can incorporate relevant information in building the test we were able to create a shortened test capable of separating suicidal and non-suicidal patients. Using all the information that is available improves the precision and utility of instruments adapted for psychiatric assessments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Backgrounde-Mental Health is an emergent area within e-Health. In the evaluation area, ecological momentary assessment (EMA) has been used to investigate separately on different psychiatric disorders while a comprehensive tool to cover the entire spectrum of mental health has not yet been developed. In this study, we aimed to present the MEmind wellness tracker and to characterize the group of patients who use it.MethodsWe developed an EMA web application: MEmind, accessed through the web page http://www.memind.net. Since 20th May 2014 on, adult outpatients (n = 13,883) attended in all psychiatric services within the Psychiatry Department of Fundación Jimenez Diaz in Madrid were proposed to use MEmind and then registered. Data collected from first year of implementation of the tool were transferred to an SPSS sheet and then analysed. A comparison between patients using and not using MEmind were performed.ResultsMEmind users (n = 2842) were significantly younger than MEmind non-users (n = 11,041) (42.2 ± 13.5 vs. 48.5 ± 16.3; P = 0.000) and mostly women (65% vs. 61.4%; P = 0.001). Also, patients with neurotic disorders were the main users of MEmind (see Table 1). Furthermore, patients with thoughts about death and suicide were more likely to use MEmind (Table 2).ConclusionsWomen, young people and patients with neurotic disorder were the main users of MEmind. Furthermore, people with suicidal thoughts were willing to use MEmind. Novel interventions for suicide prevention could be developed with the use of EMA web-based tools. Further studies are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

SummaryPurpose.This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.Materials and methods.During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.Results.Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%). An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications. The overdoses for TCA were potentially lethal in 47% of the cases. However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.Discussion.This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning. If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.Conclusion.It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose

IntroductionSuicide in public places is a relatively common emergency in which alcohol use could be a factor involved.MethodsA total of 169 patients were attended for SB in Madrid public places by SAMUR (Municipal assistance service for emergency and rescue) and transferred to FJD emergency room where all of them were assessed by the psychiatrist on duty. For all (but 47 of them), blood alcohol level was measured and other variables were collected: age, sex, history of suicide attempt and characteristic of the attempt. A descriptive analysis was made and then differences between those using alcohol and those not was made.ResultsOur sample comprises 169 patients, 40.2% woman and 59.8% man (median age = 39.36 years). Alcohol was measured in 122 patients, being positive in 52.4% (median alcohol level = 95.09 mg/dL). We found that 64.6% of man had consumed alcohol against the 30.2% of women (P = 0.000). 64.8% of alcohol users were discharged, against the 35.2% that not users. We admitted 28.1% of the alcohol users and 56.8% of the non-users (P = 0.007). We did not found statistically significance differences when compared patients that consumed against patients who did not regarding previous attempts, behavior (ideation, intent, non suicidal self-harm) and method.ConclusionsWhen assessed SB, we found that most of the patients were man under the alcohol influence and most of them were discharged after being evaluated. The data does not reflect the seriousness of the SB, which opens the possibility of correlating the levels of alcohol with suicidal risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionAn expanding body of research suggests that childhood trauma and adverse experiences can lead to a variety of negative health outcomes, including substance abuse, depressive disorders, and attempted suicide among adolescents and adults. Alcoholism, depressed affect, and illicit drug use, which are strongly associated with such experiences, appear to partially mediate this relationship as observed in population studies.ObjectivesWe have tested the association between early trauma and suicide attempts in a sample of suicide attempters from the Eureca International Project and a matched healthy control sample.MethodsWe have studied the prevalence of childhood stressful events compared with healthy controls in a multicentre sample of 791 suicide attempters (SA) and 630 healthy controls (C), we have measured childhood parental neglect, physical abuse, sexual abuse, and emotional abuse, using the Childhood Trauma Questionnaire (CTQ). Chi2 tests were performed using SPSS v15.0.ResultsA significant increase in prevalence of childhood trauma was found in the suicide attempters sample for all types of trauma: childhood physical abuse: 25.3% (SA) vs. 11.1% (C) (Chi2 test: 120,108 P = 0.000); childhood sexual abuse: 18.2% (SA) vs. 2.4% (C) (Chi2 test: 88,212 P = 0.000); parental neglect 25.3% (SA) vs. 1.1% (C) (Chi2 test: 164,910 P = 0.000); childhood emotional abuse: 34.9% (SA) vs. 5.6% (C) (Chi2 test: 176,546 P = 0.000).Suicide attempters were increasingly overrepresented compared with controls if experiencing more than 1 trauma: represented 77% of the sample who suffered 1 type of childhood trauma vs. more than 90% of the sample with 2 or more types of trauma.ConclusionsA powerful graded relationship exists between adverse childhood experiences and risk of attempted suicide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe use of valid and practical screening scales might ease the burden for greatly needed universal testing for mental health, substance use and dual disorders, but do they work well with all populations? Do they miss correct identification of certain groups?ObjectiveTo understand discrepancies in diagnostic prediction using the AC-OK screen in conjunction with other standardized assessment scales.MethodsTwo hundred and twenty-six Latino participants were recruited from primary care and community clinics in Madrid, Barcelona and Boston and assessed with standardized mental health and substance abuse measures including the AC-OK screen and with a Computerized adaptive test for mental health (CAT-MH). A measure of frequency of discrepancies and an adjusted and unadjusted comparison of results and demographic characteristics or respondents were made for mental health, substance abuse or for discrepancies in both categories.Results35.4% of cases were discrepant in mental health (AC-OK-Mental Health vs. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7 or PTSD Checklist) and 14.2% in substance abuse (AC-OK-substance abuse vs. drug abuse screening test or Alcohol use disorders identification test). When CAT-MH scale was incorporated, discrepant results were found in 24.3% and 14.2%, respectively. No association was found between substance abuse discrepancies and patient demographics. In logit regressions being from Barcelona, of younger age and male were significant predictors of discrepancies.ConclusionsDiscrepancies were observed in the diagnostic prediction, with differences detected for site and sociodemographic characteristics of participants suggesting the importance of testing screeners for site and population differences. Evidence for the misclassification of young males is discussed. Caution is warranted in the implementation of screeners for at risk populations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction Previous findings suggested that electrodermal hyporeactivity has a high sensitivity (up to 97%) and high raw specificity (up to 98%) for suicide. Aim To evaluate prevalence, sensitivity and specificity of electrodermal hyporeactivity for suicide and suicide attempt, with and without death intent and with violent method or not, in adult patients with a primary diagnosis of depression . Methods At each study site at least 100 patients with a primary diagnosis of depression, also in remission, will be recruited. Depressive symptomatology will be evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts will be registered and the death intent of the worst attempt will be rated according to the first eight items of the Beck Suicide Intent Scale. The risk of suicide will be assessed according to rules and traditions at the centre. The EDOR Test (ElectroDermal Orienting Reactivity) will be performed. Two fingers are put on gold electrodes. Through headphones a moderately strong tone is presented now and then during the test. Sensors located within the electrodes are able to register the electrodermal response to those tones, measuring the skin conductance (i.e. electrodermal activity from sweat gland activity). Each patient will be followed up for one year for actions of intentional self-harm that require medical care and for suicide. The death intent will also be rated. Expected results It is expected that the EDOR test detects a previously unknown neuropsychological dysfunction that is independent of the depressive state and can predict suicidality with a high sensitivity and specificity.

Introduction Public hospital systems have struggled to identify ways of cutting costs while improving quality of mental health treatment, even more since the economic downturn. Objective To compare mental health care expenditures and quality in two large sites, Boston and Madrid, and to analyze the amount of the expenditure corresponding to pharmacy, ER, outpatient and inpatient care. Methods Data are mental health electronic records from three hospitals in Madrid (n=31,183 person-years) and in Boston(n=8,805). Adequacy of care was measured as four or more visits within the last year. Unadjusted comparisons of variables were conducted using t-tests. Multivariate generalized linear regression models were computed with log link and residual variance proportional to mean squared, adjusting for covariates. Results were also adjusted for World Bank Purchasing Power Parity and converted to U.S. dollars. Results The annual average treatment expenditure is $4,874 in Boston and $2,693 in Madrid . Boston patients had a bigger percentage of use (13,6% vs 5,3%) and greater annual expenditure ($25,175 vs $15,470) for inpatient services (p Conclusions Emphasis on outpatient care appears to reduce inpatient stays and global expenditures. An earlier recognition due to a more open access to treatments in Spain may help decreasing costs. Bipolar, psychotic and alcohol disorders imply bigger costs.

Introduction Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also acceptable to suicide attempters. Objective The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. Method The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self–harm, from emergency services or after a short hospitalization. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly during 6 month. The text message enquires about the patients’ well-being and includes information regarding individual sources of help and evidence-based self help strategies. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, suicidal behaviour at month 6 and 13 and Medical costs at month 13. Results Results will be accepted regarding the preliminary results of the study. Discussion This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts.

The total cost of mental illness in Europe was estimated at 800 billion euros per year in 2011, more than the combined cost of cardiovascular disease, diabetes and cancer. Despite prevention efforts, over 1 million people die due to suicide and 10 to 20 million people attempt suicide every year. The development of treatment programs deals with psychopathological, neurobiological, sociodemographic, cultural and ethical issue. Over the last decade, medical assessments have been supported by the emergence of data collection tools, such as electronic health records (EHR) and personal heath records (PHR). These tools are used to enhance communication between medical providers, patients and caregivers. They offer new opportunities for medical decision-making and patient communication.The MEmind project is a longitudinal observational study proposed to patients suffering from mental disorders. This mental health tracker embodies the EHR and PHR, monitoring and interventional systems. Since July 2014, 6000 patients have participated in the study. Based on the patient’s experience of the MEmind project, we will first present the results of an acceptability study of the bi-modal mental health tracker. Then we will explore the effects of the mental health tracker on psychopharmacological monitoring and management. Finally, we will discuss the potential of such tools in preventing suicide attempts.

Introduction In the absence of biological measures, diagnostic long-term stability provides the best evidence of diagnostic validity.Therefore,the study of diagnostic stability in naturalistic conditions may reflect clinical validity and utility of current schizophrenia diagnostic criteria. Objectives Describe the diagnostic evolution of schizophrenia in clinical settings. Methods We examined the stability of schizophrenia first diagnoses (n=26,163) in public mental health centers of Madrid (Spain).Probability of maintaining the diagnosis of schizophrenia was calculated considering the cumulative percentage of each diagnosis per month during 48 months after the initial diagnosis of schizophrenia. Results 65% of the subjects kept the diagnosis of schizophrenia in subsequent assessments (Figure 1). Patients who changed (35%) did so in the first 4-8 months. After that time gap the rates of each diagnostic category remained stable. Diagnostic shift from schizophrenia was more commonly toward the following diagnoses: personality disorders (F60), delusional disorders (F22), bipolar disorder (F31), persistent mood disorders (F34), acute and transient psychotic disorders (F23) or schizoaffective disorder (F25). Conclusions Once it is confirmed, clinical assessment repeatedly maintains the diagnosis of schizophrenia.The time lapse for its confirmation agrees with the current diagnostic criteria in DSM-IV. We will discuss the implications of these findings for the categorical versus dimensional debate in the diagnosis of schizophrenia.

Introduction The diagnosis of Posttraumatic Stress Disorder (PTSD) and the experience of childhood maltreatment have been independently associated with a higher risk for suicide attempts. Objectives To investigate if PTSD diagnoses following childhood abuse are correlated with markers of suicide severity, such as the age at the first suicide attempt, the number of attempts or the suicidal intent. Methods We studied a sample of 726 suicide attempters. Lifetime clinical diagnoses and history of childhood abuse were registered. The association of PTSD and childhood abuse dimensions with age at first suicide attempt, number of suicide attempts and suicide intent was studied. An adjusted multinomial logistic regression was performed to ascertain if combined childhood abuse and PTSD increased the severity of the suicidal behavior. Results Several types of childhood abuse (emotional, physical and sexual abuse) when combined with a lifetime diagnosis of PTSD showed an increased risk for more suicide attempts and a higher level of suicidal intent compared with the absence of any or both risk factors. Conclusions The combination of PTSD and childhood abuse should be investigated in clinical settings due to an augmented risk for more severe suicidal behavior. Download : Download full-size image [Suicide intent associated with PTSD and/or abuse]

Introduction Goodman expanded the conceptualization of addictions to embrace not only drug addiction but other behavioral addictions. In some cases, suicidal behaviour can be viewed as a behavioral addiction. Objectives The main objective of the present study is to analyze the relationships between major suicide repeaters (> or =5 lifetime suicide attempts) and measures of suicidal behaviour addiction. Aims To characterize major suicide repeaters. Methods Sample and procedure: This is a transversal study of 954 suicide attempters (Montpellier, France). All suicide attempters were assessed using a protocol including: MINI (Axis I disorders), TPQ (personality traits) and BIS-10 (impulsivity), among others. Statistical Analyses: Comparisons between groups was made using logistic regression models with crude odds ratios and 95% confidence intervals. Results Major repeaters were more likely to be female and having low educational level than non-major repeaters (OR[95%]=6.95[3.19–15.10]; p Conclusions Our preliminary results give partial support to the addictive hypothesis of suicidal behaviour.

Recently, several authors have argued in favor of extending the less common clinical phenotype of schizophrenia to a vulnerability phenotype of schizophrenia in the general population. It has been proposed that high levels in any of four different symptom dimensions (affective, psychosis, negative and cognitive) would lead to clinical assessment, identification of correlated symptoms in other dimensions and finally, the diagnosis of schizophrenia. Being so, we would expect to find such a dimensional pattern in the previous diagnoses of schizophrenic patients. We examined previous contacts of a large cohort of patients diagnosed, according to the International Classification of Diseases (ICD-10), with schizophrenia (n = 26,163) in public mental health centers of Madrid (Spain) from 1980 to 2008. Of those patients, 56.7% received another diagnosis prior to schizophrenia. Non-schizophrenia diagnoses within the category of ‘schizophrenia, schizotypal and delusional disorders’ were common (F2; 40.0%). The other most frequent prior diagnoses were ‘neurotic, stress-related and somatoform disorders’ (F4; 47.3%), ‘mood disorders’ (F3; 41.4%), and ‘disorders of adult personality and behavior’ (F6; 20.8%). We then examined the probability of progression to schizophrenia, considering also time proximity. The strongest associations were between several F2 spectrum diagnoses with schizophrenia. However, some affective disorders (F3x) were also linked with schizophrenia but anxiety (F4) or personality disorders (F6) were not. Our findings support two of the previously described dimensions (psychotic, affective) in the development of schizophrenia. Several limitations of the dimensional model will be discussed in view of these findings.

Introduction Pre- and perinatal insults, childhood maltreatment, and personality traits have been separately related to suicidal behavior. Objectives To explore if all these factors act in an additive fashion. Aims To examine characteristics of suicide attempts in a life course perspective. Methods Sample and procedure: Cross-sectional study of 1042 suicide attempters. Indexes of pre- and perinatal adversity were hospitalization in neonatology, very premature birth ( Results We found an additive effect between prematurity and sexual abuse (OR[95%] = 3.57[1.03–12.50];p Conclusions Pre- and perinatal insults, childhood maltreatment, and personality traits influence in an additive fashion characteristics of suicide attempts.

BackgroundNatural polyamines (putrescine, spermidine and spermine) are low molecular weight highly protonated aliphatic molecules that physiologically modulate NMDA, AMPA/kainate glutamatergic receptors and limbic dopaminergic neurotransmission. Previous studies had demonstrated that polyamine metabolism might be disrupted in schizophrenia, what could potentially be linked to glutamatergic dysfunction. In particular, polyamine levels in blood and fibroblast cultures from patients with schizophrenia had previously been found to be higher than in healthy controls. Indeed, a significant positive correlation between blood polyamine levels and severity of illness may exist.MethodsIn order to test potential differences in blood polyamine levels between drug-free schizophrenia in-patients (n = 12), and healthy controls (n = 26, blood donors), spermidine (spd), spermine (spm), and spermidine/spermine index (spd/spm) were determined using HPLC after dansylation.ResultsNo significant differences were found between groups (t = 0,974; df = 36; P = 0,337 for spd, t = l0, 52; df = 36; P = 0,959 for Spm, and, t = 0, 662; df = 36; P = 0,512 for spd/spm).ConclusionsThough we couldn’t replicate previous findings suggesting disturbances in blood polyamine levels in schizophrenia, this issue may be a promising target. Future research should take into account possible factors such as sex, nutritional state, and stress.

BackgroundA growing interest in the potential role of polyamines in stress, mood disorders and suicidal behavior has recently emerged. In particular, the expression of polyamine's rate-limiting catabolic enzyme (SAT-1, Spermidine/spermine N1-acetyltransferase-1) may be reduced in ventral prefrontal cortex and posterior cyngulate gyrus of patients who committed suicide. However, there is some controversy regarding the involvement of potential cis-acting loci controlling SAT-1 gene expression (rs6526342 or rs17286006) in suicidal behavior. Moreover, a significant association between SAT-1 rs1960264 SNP and anxiety disorders has been found in a male caucasian spanish sample.MethodsIn order to test the potential association of SAT-1 -1415T/C SNP (rs1960264) with suicidal behavior, genotype frequencies for that SNP were compared between 193 suicidal attempters (126 female and 67 male) and 650 non-suicidal patients (314 female and 336 male) from an in-patient sample.ResultsWe could not find a significant difference in the distribution of the genotypes for rs1960264 SNP between suicide attempters versus non-suicidal individuals (Linear-by-Linear association X2 = 0,203; df = 1; P = 0,652, females; Linear-by-Linear association X2 = 0,000; df = 1; P = 0,990, males). Neither could we demonstrate a relationship between rs1960264 genotype and past history of suicidal attempts (Linear-by-Linear association X2 = 2,966 ; df = 1; P = 0,085, females; Linear-by-Linear association X2 = 1,171; df = 1; P = 0,279, males).ConclusionsAlthough we did not find a link between rs1960264 genotype and suicidal behavior, SAT-1 may be an interesting target to investigate the biology of this phenotype. Future studies should take into account other genetic polymorphisms at SAT-1, and definitively evaluate whether or not rs6526342 and rs1960264 have any functional implications.

Diagnostic stability is the measure of the degree to which a diagnosis remains the same at subsequent assessments of the patient and constitutes a longitudinal validation of the original baseline diagnosis. Follow-up studies including evidence of diagnostic stability and diagnostic consistency over time have been proposed to test the validity of psychiatric diagnoses. Until this moment definitions for psychiatric diagnoses are based on expert opinion rather than on their biological basis, and the modest knowledge base regarding underlying etiologies has hindered the use of etiological factors in psychiatric classification systems. But it is assumed that the higher the diagnostic stability, the more likely is to reflect a consistent psychopathological or pathophysiological process. Being that the main clinical purpose of diagnosis, as a formulation, is to furnish the informational basis for planning and conducting clinical care, stability of a diagnosis gives a relevant base not only for prediction of the course and outcome of a disorder but also for effective planning and provision of treatment. The availability of longitudinal data, however, may cause significant fluctuations in diagnostic stability as changes in clinical presentation are seen. Thus, evolving longitudinal observations should lead to periodic updating of the comprehensive diagnostic formulation, and yet, despite the inherent problems derived from criteria based on cross-sectional observations, our diagnostic system relies on stable diagnoses. Accounting for the potentially harmful consequences of unsuitable treatment options or clinical interventions, the study of diagnostic stability remains an essential issue in psychiatry.

Introduction:Adoption, twin and family studies suggest that suicide behavior is familial and heritable. Both completed and attempted suicide appear to be transmitted in a familial form. Genetics and environment influences had been detected in various studies. But suicidal behavior suggests to be inherited independently from the mental disorders usually associated with it. While traditional statistics emphasizes inference and estimations, data mining emphasizes the fulfillment of a task such as classification, estimation, or knowledge discovery.Objectives:The goal of this study was to determine in a large sample of suicide attempts which variables are associated with family history of attempted suicide.Methods:In an emergency room, 539 adult suicide attempters were recruited. The two dichotomous dependent variables were family history of suicide attempt (10%) and of completed suicide (4%). Independent variables were 101 clinical variables explored with two data mining techniques: Random Forest and Forward Selection.Results:A model for family history of completed suicide could not be developed. A classificatory model for family history of attempted suicide included the use of alcohol in the intent and family history of completed suicide, provide a sensitivity of 78.4%, a specificity of 98.7% and accuracy of 96.6%.Conclusions:A classificatory model for family history of completed suicide could not be developed using data mining techniques. But it suggested that the use of alcohol in the intent and family history of completed suicide may be associated with familial attempted suicide.