Pre- and perinatal insults, childhood maltreatment, and personality traits have been separately related to suicidal behavior.

To explore if all these factors act in an additive fashion.

To examine characteristics of suicide attempts in a life course perspective.

Sample and procedure: Cross-sectional study of 1042 suicide attempters. Indexes of pre- and perinatal adversity were hospitalization in neonatology, very premature birth (< 31 weeks of pregnancy), tobacco during mother's pregnancy, and mother's and father's age at patient's birth. All suicide attempters were evaluated using the French version of the Childhood Trauma Questionnaire, and the Tridimensional Personality Questionnaire. Characteristics studied in suicide attempters included violence of suicide attempt, age at first suicide attempt, and number of suicide attempts. Statistical Analyses: Comparisons between groups was made using c2 with crude and adjusted odds ratios, and 95% confidence intervals. All analyses were adjusted for gender, age, study level, Alcohol dependence or abuse, Substance dependence or abuse, Tobacco, Episode of major depression, Bipolar, Anxiety, Eating disorders, and Schizophrenia.

We found an additive effect between prematurity and sexual abuse (OR[95%] = 3.57[1.03–12.50];p < 0.001), emotional abuse (OR[95%] = 4.54[1.76–12.50];p < 0.05), novelty seeking (OR[95%] = 9.09[1.76-12.50];p < 0.001), and harm avoidance (OR[95%] = 5.88[2.38-14.28];p < 0.001) for a younger age at first suicide attempt. Tobacco during mother's pregnancy, and harm avoidance also had an additive effect on the age at first suicide attempt (OR[95%] = 4.76[1.96–11.11];p < 0.05) and number of suicide attempts (OR[95%] = 3.31[1.37–7.99];p < 0.05).

Pre- and perinatal insults, childhood maltreatment, and personality traits influence in an additive fashion characteristics of suicide attempts.