This is a prospective longitudinal study, with a nested case-control substudy, of a cohort of persons aged 18 years or older (n~900) with a prior suicide attempt, registered in the Catalonia Suicide Risk Code Pprogramme (CSRC Programme) by five hospitals participating in the study: Consorci Hospitalari del Parc Taulí de Sabadell (Barcelona), Consorci MAR Parc de Salut de Barcelona, Hospital de Sant Pau i la Santa Creu de Barcelona, Institut d'Assistència Sanitària de Girona and Institut Pere Mata de Reus (Tarragona). Participants will be followed up for 12 months. The catchment areas of these hospitals encompass a population of approximately 2.5 million inhabitants in Catalonia (33%).
The nested case-control substudy in the cohort will analyse the sociodemographic, clinical, neuropsychological and biological differences among persons making a repeat suicide attempt (n~100), and control participants (n~100): (1) healthy persons (with no prior suicide attempts or a family history of suicide attempts) and (2) persons with a single suicide attempt. A repeat suicide attempt will be defined as any further suicide attempt occurring a minimum of 30 days after the first suicide attempt registered in the CSRC Programme.
Persons making a suicide attempt and repeat suicide attempt will be assessed within 10 days after hospital discharge, using clinical and neuropsychological tests. We will also gather sociodemographic information and collect biological samples of blood and hair. The sample of healthy controls will be evaluated with the same assessment tests.
A magnetic resonance imaging (MRI) study will be performed including several sequences: (1) a three-dimensional (3D) structural sequence; (2) a T2 sequence and FLAIR sequence to assess possible structural findings; (3) a resting state MRI, and (4) a functional stress task, consisting of the Montreal imaging stress task (MIST), which is an adaptation of the “Trier Mental Challenge Test” comprising a computerized series of arithmetic tasks with an induced failure component (time limit for performance) and an additional social stress component aiming to measure the stress response pattern in the brain in laboratory conditions.